Home infusion drug pricing

Home infusion drugs are those drugs (including chemotherapy drugs) that cannot be taken orally and are administered in the home by other means: intramuscularly, subcutaneously, intravenously or infused through a piece of DME. DME verification is not required.

Home infusion drugs are reimbursed according to TRICARE policy. These drugs must be billed using an appropriate HCPCS code along with a specific National Drug Code (NDC) for pricing.

Claims for home infusion will be identified by the place of service and the CMS HCPCS National Level II Medicare codes, along with the specific NDC number, drug units and quantity of the administered drug.