CMS proposes payment methodology for home infusion drugs

Friday, July 12, 2019

WASHINGTON – CMS has issued a proposed rule that would group home infusion drugs into three payment categories in preparation for the new home infusion benefit that starts in 2021. Each category would have a single unit of payment in accordance with specified infusion codes under the physician fee schedule. CMS is also proposing higher payment amounts for the first home infusion therapy visit, along with a small decrease in the payment amounts for each subsequent visit to make the adjustments budget neutral. The 21st Century Cures Act, passed in 2016, requires Medicare to pay for home infusion services associated with Part B infusion drugs.