CMS Reverses Course on Changing HCPCS Codes, Billing Units for Ig
August 17, 2026
NHIA commends CMS for listening to stakeholders and deciding not to move forward at this time
The National Home Infusion Association actively engages federal agencies to advance policies that reduce fragmentation, recognize pharmacy professional services, and preserve patient access to care at home. These efforts are grounded in the principle that sound regulatory policy must reflect the true cost and complexity of delivering high-quality care outside the hospital setting. NHIA’s regulatory advocacy is most effective when the industry speaks together. We invite members to engage and make their voices heard.
After receiving feedback from members, the association submitted comments to CMS on the proposed rule that includes implementation of the Joe Fiandra Access to Home Infusion Act as well as steps in the agency’s continued focus on fraud and abuse.
Watch the recent Talk Infusion recording to hear what we said about implementing the Joe Fiandra Access to Home Infusion Act, CMS’s continued fraud and abuse focus, and the newly released draft guidance on Part B Effectuation of Maximum Fair Price for 2028.
CMS released the proposed 2027 “Home Health Rule,” which includes details on the implementation of the Joe Fiandra Access to Home Infusion Act. The Fiandra legislation was enacted earlier this year to expand Medicare coverage for a narrow subset of home infusion therapies that require both an external infusion pump and administration by a health care professional.
Members Only
TALK INFUSION: Joe Fiandra Act Implementation: What the Calendar Year 2027 Proposed Rule Means for Home Infusion
NHIA policy experts provide an in-depth review of CMS’s proposed implementation and what it means for providers, manufacturers, and patients. This member-only webinar will examine how CMS proposes to define eligible drugs, interpret statutory requirements, and operationalize coverage under the Medicare Part B DMEPOS benefit.
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.
Explore a Talk Infusion Webinar and other resources on the proposed coding changes.
NHIA commends CMS for listening to stakeholders and deciding not to move forward at this time
This proposal to modify the criteria for the use of an infusion pump should not be
NHIA submitted comments to CMS on a new proposed rule on interoperability and prior authorization for