CMS Reverses Course on Changing HCPCS Codes, Billing Units for Ig
NHIA commends CMS for listening to stakeholders and deciding not to move forward at this time with the proposed changes to HCPCS codes and billing units for immune globulin products.
FOR IMMEDIATE RELEASE
Alexandria, VA — January 8, 2026 — The National Home Infusion Association (NHIA) President and CEO Connie Sullivan testified today before the House Energy and Commerce Committee Subcommittee on Health in support of the Preserving Patient Access to Home Infusion Act (H.R. 2172). The hearing marked a major milestone for the legislation, with Members from both parties emphasizing the need to strengthen Medicare and remove barriers that keep seniors from receiving clinically appropriate infusion care at home.
The hearing comes on the heels of NHIA’s largest Hill Day to date, during which NHIA members held more than 130 meetings with elected officials and congressional staff to build support for improving Medicare beneficiary access to home infusion therapy.
“The strong bipartisan engagement we saw today is exactly the momentum seniors and families have been waiting for,” said Sullivan. “Congress is increasingly recognizing that Medicare’s home infusion benefit is incomplete and, as a result, too many beneficiaries are pushed into facilities even when receiving therapy at home is safe and workable.”
Despite many well-established benefits, access to home infusion has largely been out of reach for patients with traditional Medicare due to the program’s narrow and incomplete benefit design. Sullivan described how home infusion typically works as well as the limitations of the current benefit compared to coverage provided by commercial payors. “Medicare still does not have a complete home infusion benefit, and this bill addresses a real access problem for America’s seniors and people with disabilities,” Sullivan explained. “Without home infusion access, seniors must travel back and forth to facilities or extend their hospital stay to receive these necessary (and often lifesaving) treatments.”
The Preserving Patient Access to Home Infusion Act takes practical steps that would increase Medicare beneficiaries’ access to home infusion. Specifically, the bill would modernize the home infusion professional services benefit to reflect the full scope of services, expand the benefit to improve access to IV anti-infective therapies, bundle disposables and supplies into the services payment, and recognize nurse practitioners and physician assistants in ordering home infusion therapy. Learn more about the legislation.
“Today’s hearing is an important step forward—and it underscores that the case for fixing Medicare’s home infusion benefit resonates on both sides of the aisle,” Sullivan added. “NHIA looks forward to working with Committee leaders and bill sponsors to keep moving this legislation toward enactment.”
“Thanks to NHIA members who have consistently worked to raise awareness of the beneficiary access issues with policymakers,” added Sullivan. “Your first-hand perspective is invaluable to the process, and we will keep you updated on next steps.”
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National Home Infusion Association (NHIA) is a trade association that represents companies accredited to provide medically necessary infusion therapies to patients with acute and chronic health conditions, as well as companies that manufacture and supply infusion related products and services. Infusion therapy involves patient-specific compounded medications, supplies, and a range of pharmacy, nursing, and other clinical services for delivering care to patients in the home or suite setting.
NHIA commends CMS for listening to stakeholders and deciding not to move forward at this time with the proposed changes to HCPCS codes and billing units for immune globulin products.
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 home.
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 know that home infusion may not fit neatly into processes designed for medical and pharmacy benefits.
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