CMS NEWS
FOR
IMMEDIATE RELEASE
May
6, 2021
Contact:
CMS Media Relations
CMS
Media Inquiries
CMS
Increases Medicare Payment for COVID-19 Monoclonal Antibody Infusions
New
payment policy for at-home administration
As
part of the ongoing response to address the COVID-19 pandemic, the Centers
for Medicare & Medicaid Services (CMS) has increased the Medicare
payment rate for administering monoclonal antibodies to treat beneficiaries
with COVID-19, continuing coverage under the Medicare Part B COVID-19
vaccine benefit. Beneficiaries pay nothing out of pocket, regardless of
where the service is furnished – including in a physician’s office,
healthcare facility or at home.
Effective
today, the national average payment rate will increase from $310 to $450
for most health care settings. In support of providers’ efforts to prevent
the spread of COVID-19, CMS will also establish a higher national payment
rate of $750 when monoclonal antibodies are administered in the
beneficiary’s home, including the beneficiary’s permanent residence or
temporary lodging (e.g., hotel/motel, cruise ship, hostel, or homeless
shelter).
The
new national payment rate for at-home administration of monoclonal
antibodies accounts for increased costs associated with the one-on-one
nature of this care model. These higher national average payment rates
reflect additional information provided to CMS about the costs of providing
these services in a safe and timely manner, such as clinical staff and
personal protective equipment. This action also means Medicare payments to
providers and suppliers will be more aligned to their costs to administer
these products.
CMS’s
goal during the COVID-19 PHE has been to ensure that the agency is
supporting beneficiary access to care. This new policy is based on
timely, valuable input from stakeholders including the home health and
ambulatory infusion industries on the costs associated with administering
monoclonal antibodies.
CMS
is updating the set of toolkits
for providers, states and insurers to help the health care system
swiftly administer monoclonal antibody treatment with these new Medicare
payment rates, at https://www.cms.gov/medicare/covid-19/monoclonal-antibody-covid-19-infusion.
In
addition, CMS is updating coding resources for providers, at https://www.cms.gov/medicare/medicare-part-b-drug-average-sales-price/covid-19-vaccines-and-monoclonal-antibodies.
For
additional clinical information about COVID-19 monoclonal antibodies,
please visit:
###
Get CMS news at cms.gov/newsroom,
sign up for CMS news via
email and follow CMS on Twitter @CMSgov
|
No comments:
Post a Comment