Reimbursement considerations for home infusions

Home infusion and injection services are growing in popularity as a cost-effective and convenient alternative to traditional healthcare. The COVID-19 pandemic has accelerated this trend, attracting attention from payers and pharmaceutical manufacturers. However, accessing home infusion care still poses challenges. Medicare provides coverage options for different aspects of home infusion but lacks a unified framework. While Part A Home Health covers skilled nursing infusion services, it excludes drug and external infusion pump coverage. Medicare Part D covers the drug but not the pump or nursing service, and Part B's DME benefit covers some pumps and drugs but not the necessary nursing service. The Part B Home Infusion Therapy benefit addresses some gaps but has provider qualifications and excludes drug and pump coverage. For a comprehensive understanding of access options, download this white paper for valuable insights.