IVIG Demonstration Extended until 12/31/2023

December 31, 2020

On December 21, 2020, Congress passed the “Consolidated Appropriations Act, 2021. Division CC, Section 104 of this legislation, extends the Medicare IVIG Demonstration through December 31, 2023. Beneficiaries previously enrolled in the demonstration, as of November 15, 2020, will be able to continue in the demonstration and do not need to take any action. No re-enrollment in the program is required. Suppliers can continue to provide and will be paid for demonstration services to eligible and enrolled beneficiaries, beginning on January 1, 2021.

Intravenous Immune Globulin (IVIG) Demonstration

The Medicare Intravenous Immune Globulin (IVIG) Demonstration is being implemented to evaluate the benefits of providing payment and items for services needed for the in-home administration of intravenous immune globulin for the treatment of primary immune deficiency disease (PIDD). The demonstration started on October 1, 2014.

IVIG Demonstration Fact Sheet

Background

The Medicare IVIG Demonstration is authorized per legislation. Under the demonstration there will be a per-visit payment amount for items and services needed for the in-home administration of IVIG.

Noridian Healthcare Solutions, LLC, the DME MAC for Jurisdiction A, is the Implementation Support Contractor for the IVIG Demonstration as of July 1, 2016.

Beneficiary Eligibility for Demonstration Participation

Applications for participation in the IVIG Demonstration will continue to be accepted on a rolling basis until Medicare reaches or projects it will reach the statutory limit on funding ($45 million including all costs for services, implementation and evaluation of the demonstration) and/or enrollment. The demonstration is scheduled to end December 31, 2023 (the last day to apply for coverage under this demonstration is November 15, 2023).

In order to enroll in the IVIG Demonstration, a beneficiary must:

  • Be covered under Medicare Fee-For-Service and enrolled in Part B,
  • Have a diagnosis of Primary Immune Deficiency Disease (PIDD), and
  • Not be currently covered under a home health episode of care.

Visit Information for Beneficiaries to access a copy of the IVIG Enrollment Application and instructions on how to properly complete and submit the form.

Providing and Billing for the In-Home Administration of IVIG

Services covered under the demonstration shall be provided and billed by the specialty pharmacies that provide the immune globulin drug, which is already covered under Medicare Part B. The new demonstration covered services will be paid as a single bundle and will be subject to coinsurance and deductible as are other Part B services.

View Provider and Supplier for more information.

To ask IVIG questions or send information to Noridian, see the Contact Us webpage.

Last Updated Mon, 16 Aug 2021 17:27:57 +0000