You need to know that billing for home infusion therapy (HIT) means giving drugs or treatments to people at home, like through an IV.

Usually, you need to bill home infusion therapy under Fee-for-Service Medicare and you always need you need the drug (like antivirals or immune globulin), equipment (like a pump), and supplies (like tubing and catheters) for performing home infusion services and procedures. You should also use nursing services to educate the caregivers and patients about the safe usage of the infusion treatments.

If you work with an infusion billing company, they can help you understand Medicare coverage, find the right suppliers, and know which billing codes to use for home infusion therapy services.

You need to know the exact Medicare coverage for your infusion billing practice so that you can always receive payments on time.

Understand the Medicare coverage

You should know that Medicare covers home infusion therapy services, like nursing services, patient training, and remote monitoring when it’s part of the care plan. These services help safely give certain drugs at home, either through an IV or under the skin, for 15 minutes or more. A qualified supplier provides these services at home, and the infusion pump and supplies (like drugs) are covered under the durable medical equipment (DME) benefit. The home infusion therapy benefit ensures that patients get the right care for safe treatment at home and a professional home infusion therapy supplier can bill for the provided infusion services in a patient’s home. You must know who a qualified home infusion therapy supplier is.

Know about the qualified home infusion therapy supplier

You need to know that only a qualified home infusion therapy supplier can bill for services under the new home infusion therapy benefit. To be qualified, the supplier must be approved by a Medicare Accreditation Organization (AO) and enroll in Medicare as a Part B supplier (specialty D6). If a supplier already works as a DME supplier or Home Health Agency, they should think about enrolling as a home infusion therapy supplier if they want to offer services beyond the DME or Home Health benefit. An infusion billing company can help make sure everything is done right!

Now, it is really important for you to know how a professional infusion billing company performs coding for documenting home infusion therapies so that you can streamline a perfect billing practice and receive prompt reimbursements.

Frequent home infusion therapy billing codes used by infusion billing companies

You must always assign HCPOCS codes G0088, G0089 and G0090 for documenting all your home infusion therapy (HIT) service visits only. These codes were made for the permanent HIT benefit. Make sure you are not use these codes for Temporary Transitional Payment (TTP) period.

G0068

You need to know that professional services for giving certain drugs like anti-infectives, pain management drugs, or other intravenous medicines at home are covered. This includes drugs for things like pulmonary hypertension or inotropic treatments, but not chemotherapy or really complex drugs. These services are covered for each 15-minute time period the drug is given at home, on each day of the treatment.

G0088

You should know that professional services are covered for the first visit when giving certain drugs like anti-infectives, pain management drugs, or other intravenous medicines at home. This also includes treatments for things like pulmonary hypertension or inotropic treatments, but not chemotherapy or really complicated drugs. These services are covered for each 15-minute period that the drug is given at home, every day the treatment happens.

G0089

You should know that professional services are covered for the first visit when giving subcutaneous immunotherapy or other subcutaneous infusion drugs at home. This means every 15 minutes the drug is given at home, and each day of the treatment, is covered.

G0090

You need to know that professional services are covered for the first visit when giving intravenous chemotherapy or other complicated infusion drugs at home.

You might have already realized the truth that managing infusion billing services is not an easy affair. You need professional help and hiring an efficient infusion billing company could be a smart decision for you. A professional infusion billing company has adequate experience and expertise to streamline a robust billing process for you, enabling you to enjoy a substantial revenue boost along with excellent cost-savings.