To compare how a medication is covered by all Medicare Part D plans in a service area, on this site.
To be eligible to receive home infusion therapy services under the home infusion therapy benefit, a beneficiary must have Medicare Part B and meet each of the following requirements:
- The beneficiary must be under the care of an applicable provider, as defined in
section 1861(iii)(3)(A) of the Act as a physician, nurse practitioner, or physician
assistant.
- The beneficiary must be under a physician-established plan of care that meets the
requirements specified in 42 CFR 414.1515 and 42 CFR 486.520, as described in
section 320.5 of this chapter.
CMS states:
"'Home infusion drugs' are defined as parenteral drugs and biologicals administered intravenously, or subcutaneously for an administration period of 15 minutes or more, in the home of an individual through a pump that is an item of DME covered under the Medicare Part B DME benefit... '[H]ome infusion drugs' does not include insulin pump systems or self-administered drugs or biologicals on a self-administered drug exclusion list."
Source:
https://www.cms.gov/files/document/ home-infusion-therapy-services-benefit-beginning-2021-frequently-asked-questions.pdf