Intravenous Immune Globulin Demonstration Ending: Important Information for IVIG and Infusion Suppliers

This notice contains important information for suppliers that bill for beneficiaries receiving immune globulin in their home through the IVIG demonstration program. Each of your IVIG demonstration beneficiaries will be calling you for guidance on obtaining their IVIG in 2021, so please be prepared to discuss the options and help them by reading the below information.

The Medicare IVIG Demonstration will end as of December 31, 2020. This date is based on date of service (DOS) so any claims for Q2052 billed with DOS after December 31, 2020 will be denied. Suppliers are reminded that they have one year to file claims from the date of service to avoid a timely filing denial.

Noridian will stop enrollment in the demonstration as of November 16, 2020. For mailed applications, the post mark date must be on/before November 15 for us to process the IVIG application. Faxes received by 11:59 pm Central Time on November 15 will be processed.

Since the demonstration ends on December 31, 2020, no payment will be made for demonstration services (supplies and related nursing services to administer IVIG in the home) provided after that date. The traditional Medicare fee-for-service program will continue to pay for IVIG based on coverage requirements, but once the demonstration ends, it will no longer pay for the services and supplies to administer the drug in the home, unless the beneficiary is receiving covered Medicare home health services. Beneficiaries currently receiving IVIG in their home must transition to other options for receiving IVIG, as further explained below.

  1. Receive the IVIG treatment in a doctor’s office or other outpatient setting.
  2. If medically appropriate, transition to a subcutaneous form of immune globulin that can be self-administered.
  3. In 2021, Medicare also pays for professional services (nursing services) for certain forms of immune globulin, when administered through a pump in your home, under the Home Infusion Therapy benefit. Suppliers must meet certain requirements to bill under this new benefit.

Therefore, suppliers will need to transition each patient receiving IVIG through the demonstration to another method of receiving IVIG, as discussed above, for Medicare to consider payment for the administration of the IVIG and related services and supplies. For more information on the Home Infusion Therapy benefit, see https://www.cms.gov/files/document/mm11880.pdf and https://www.cms.gov/files/document/se19029.pdf.

If you have questions regarding this, call the IVIG call center at 1-844-625-6284, Monday - Friday 8:30 a.m. - 4 p.m. CT.

            Last Updated Wed, 07 Oct 2020 14:35:52 +0000