US · guidance
CMS Pub. 100-04, ch. 17, § 80.6
Intravenous Immune Globulin
Beginning for dates of service on or after January 1, 2004, Medicare pays for intravenous
immune globulin administered in the home. (See the Medicare Benefit Policy Manual,
Chapter 15 for coverage requirements.) Contractors pay for the drug, but not the items or
services related to the administration of the drug when administered in the home, if
deemed medically appropriate.
Contractors may pay any entity licensed in the State to furnish intravenous immune
globulin. Payment will be furnished to the entity with the authority to furnish the drug.
intravenous immune glogulin Beneficiaries are ineligible to receive payment for the drug.
Pharmacies and hospitals dispensing intravenous immune globulin for home use would
bill the DME MAC. If the beneficiary is receiving treatment in an outpatient hospital, the
bill must be sent to the A/B MAC (A). If the beneficiary is receiving treatment in a
physician’s office, the bill must be sent to the A/B MAC (B). Home Health Agencies
dispensing intravenous immune globulin would bill the A/B MAC (HHH). Physicians
furnishing intravenous immune globulin for the refilling of an external pump for home
infusion would bill the DME MAC.
Effective January 1, 2006, Medicare makes an additional payment once per day per
beneficiary for preadministration-related services whenever a beneficiary receives
intravenous immune globulin.
History
(Rev. 3085, Issued: 10-03-14, Effective: ICD-10: Upon Implementation of ICD-10; ASC X12: January 1, 2012, Implementation: ICD-10: Upon Implementation of ICD- 10; ASC X12: November 4, 2014)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
f2445406844e74c0e3fcab8fb396a474a5810821427fb64b482c1bb47aba82d1
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