CMS has proposed major HCPCS coding changes for immune globulin (Ig) products effective January 1, 2027. The proposal would replace many existing 500 mg billing unit codes with new manufacturer-specific codes using smaller 100 mg or 200 mg billing units. These changes could create significant operational challenges, including system updates, claims complexity, unit conversion risks, payer adjudication changes, and staff education needs across providers, manufacturers, and payers.
Organizations can submit written comments to HCPCS@cms.hhs.gov by June 3, 2026, 5:00pm ET
NHIA strongly opposes CMS’s proposed HCPCS coding and billing unit changes for immune globulin products, arguing that the changes would create significant administrative, operational, reimbursement, and patient care challenges without providing meaningful clinical or financial benefit.
This proposal to modify the criteria for the use of an infusion pump should not be viewed as a solution to the broader access challenges facing Medicare beneficiaries who could safely receive infusion therapy at
NHIA submitted comments to CMS on a new proposed rule on interoperability and prior authorization for drugs. While NHIA is mostly supportive of standardizing prior authorization (PA) processes for Medicare-covered drugs, it wants CMS to
NHIA strongly opposes CMS’s proposed HCPCS coding and billing unit changes for immune globulin products, arguing that the changes would create significant administrative, operational, reimbursement, and patient care challenges without providing meaningful clinical or financial
The National Home Infusion Association (NHIA) has received clarification from CMS regarding enrollment options for home infusion pharmacies under the current nationwide DMEPOS enrollment moratorium.
