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Home Health PPS: Home Infusion Therapy Services

Guidance for intravenous or subcutaneous administration of drugs or biologicals to an individual at home.

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: February 27, 2020

Home infusion therapy involves the intravenous or subcutaneous administration of drugs or biologicals to an individual at home.  The components needed to perform home infusion include the drug (for example, antivirals, immune globulin), equipment (for example, a pump), and supplies (for example, tubing and catheters). Likewise, nursing services are necessary to train and educate the patient and caregivers on the safe administration of infusion drugs in the home. Visiting nurses often play a large role in home infusion. Nurses typically train the patient or caregiver to self-administer the drug, educate on side effects and goals of therapy, and visit periodically to assess the infusion site and provide dressing changes. The home infusion process typically requires coordination among multiple entities, including patients, physicians, hospital discharge planners, health plans, home infusion pharmacies, and, if applicable, home health agencies.
 

Directory of Home Infusion Therapy Suppliers  

This searchable list/directory of home infusion therapy suppliers in a specific locality will be updated bi-weekly.
 

Section 5012 of the 21st Century Cures Act

On December 13, 2016, the 21st Century Cures Act (the Cures Act) was enacted into law. Section 5012 of this new law amended sections 1861(s)(2) and 1861(iii) of the Act, and established a new Medicare home infusion therapy benefit. The Medicare home infusion therapy benefit is for coverage of home infusion therapy-associated professional services for certain drugs and biologicals administered intravenously, or subcutaneously through a pump that is an item of DME, effective January 1, 2021. Section 1861(iii)(2) of the Act defines home infusion therapy to include the following items and services: the professional services (including nursing services), furnished in accordance with the plan, training and education (not otherwise included in the payment for the DME), remote monitoring, and other monitoring services for the provision of home infusion therapy furnished by a qualified home infusion therapy supplier in the patient’s home.
 

Home Infusion Therapy Services Monitoring

The HIT monitoring report (PDF) for February 2024 summarizes utilization for the HIT service visits, characteristics of HIT users, and characteristics of DME/HIT supplier organizations for Quarter 1 2021 to Quarter 2 2023.

Home Infusion Therapy Payment Policy Questions

For questions about home infusion therapy payment policy, please view the Home Infusion Therapy Services Benefit Beginning 2021, Frequently Asked Questions (PDF) document or send your inquiry via email to: HIT_IVIGpolicy@cms.hhs.gov.

  

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DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.