IVIG Demonstration - IVIG
IVIG Enrollment Applications Only Accepted until 12/15/2023
The IVIG demonstration will be ending on December 31, 2023. However, Medicare will continue to cover intravenous immune globulin supplies and nursing services in the home for beneficiaries with a diagnosed primary immune deficiency disease, as these items and services will be covered under a permanent Medicare benefit effective January 1, 2024.
Due to the IVIG demonstration ending, the last date that enrollment applications will be accepted for the demonstration will be December 15, 2023. Applications must be postmarked or faxed by midnight on December 15, to be considered for enrollment in the IVIG demonstration. We will send a denial letter for enrollment in the demonstration for applications received after this date.
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.
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 of no more than 6,500 enrollees. 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
- Receive treatment by intravenous infusion, 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 Fri, 04 Feb 2022 22:10:23 +0000