Medicare Physician Fee Schedule

• CMS will retire the Enteral and Parenteral Nutrition National Coverage Determinations (NCDs); thus, coverage will be defined by the Local Coverage Determinations (LCDs). NHIA advocated for revising rather than retiring the NCDs due to concerns about inconsistent policies at the local level. Revised medical coverage criteria for enteral and parenteral nutrition went into effect on September 5 and are expected to greatly improve access to this benefit. To learn more, watch this webinar.  
• Special coverage for COVID-19 treatments, including administration of monoclonal antibodies in the home, will remain in place for the remainder of the year in which the public health emergency is discontinued—through the end of 2022, at the earliest. NHIA’s comments to CMS on its proposed rule emphasized the lack of home infusion coverage for Medicare beneficiaries once the PHE ends.  

Home Health Prospective Payment

• Home Infusion Therapy Services will continue to only be billable when a professional (nurse) is physically in the patient’s home on a day the covered drug is infused. 
• Initial visits will continue to be paid using the budget-neutral differential. 

• Payment rates for home infusion therapy services will continue to be adjusted geographically.  
• NHIA has worked with members of Congress to introduce legislation that would require CMS to reimburse home infusion providers for each day the patient infuses the drug and to remove the face-to-face requirement. Learn how you can support NHIA’s efforts to pass S.2652 and H.R. 5067.  

COVID-19 Vaccine Requirements for Employees and Health Care Workers

Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) rule