Home Infusion Therapy Accreditation
Medicare reimbursement rules now require accreditation for home infusion therapy suppliers. ACHC’s Home Infusion Therapy Accreditation program can assist providers in meeting the new requirements.
Under the new rules, agencies providing infusion nursing services to Medicare-eligible patients can bill Medicare Part B if they are accredited for home infusion therapy.
ACHC is recognized by the Centers for Medicare & Medicaid Services (CMS) as a national accreditor for home infusion therapy suppliers. This gives ACHC deeming authority to conduct surveys that meet or exceed Medicare requirements, including reimbursement rules mandated by the 21st Century Cures Act that became effective January 1, 2021.
Our Home Infusion Therapy Accreditation program looks at the education, assessment, medication review, and development of the plan of care and administration provided by a nurse in the home. ACHC staff and industry experts developed standards that conform to industry best practices, with realistic expectations for business operations.
Educational resources, including crosswalks that detail all standards changes and FAQs, are available. ACHC and Imark Billing are also offering a Home Infusion Therapy Billing Tip Sheet that includes the latest payment rates and corresponding codes.
For more information on ACHC Home Infusion Therapy Accreditation, please email customerservice@achc.org or call (855) 937-2242.
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Home Infusion Therapy Accreditation Services
ACHC's nationally recognized services include:
Home Infusion Therapy Supplier (HITS) services involve the administration of parenteral medications via various accesses and ports provided by a qualified Registered Nurse (RN), Licensed Practical Nurse (LPN), or skilled professional, as allowed by state regulations, specifically trained in these specialized services. These services are provided in the home. A Registered Nurse or Pharmacist is responsible for supervision of all HITS services.
NOTE: Beginning in 2021, providers seeking to meet the Conditions for Coverage (CfCs) to receive Medicare reimbursement for infusion nursing services provided in the home must be accredited under ACHC’s Home Infusion Therapy Accreditation program
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Home Infusion Therapy Accreditation FAQs
The 21st Century Cures Act, which was signed into law on December 13, 2016, called for the creation of a bundled payment for providers that supply home infusion therapy services to Medicare beneficiaries. A requirement of the Act stipulated that home infusion suppliers be accredited by an accrediting organization approved by the Centers for Medicare & Medicaid Services (CMS) to receive Medicare reimbursement.
Effective January 1, 2021, all home infusion therapy suppliers must be accredited to receive Medicare reimbursement.
Yes. CMS has recognized ACHC as a national accrediting organization for home infusion therapy suppliers. The decision gives ACHC deeming authority to conduct surveys that meet or exceed Medicare requirements, including the new reimbursement rules mandated by the 21st Century Cures Act.
Yes. All organizations that want to bill Medicare Part B for home infusion therapy services need an additional one-day survey to achieve Home Infusion Therapy Accreditation.
Each location is required to have its own NPI and PTAN numbers. If home health and private duty nursing providers want to provide services and bill separately, they must apply for a Medicare Part B billing number to bill for professional services provided in the client’s/patient’s home. This means that each location must be accredited.
Accredited home infusion therapy organizations can submit an 855B application form to their MAC. Organizations must include the application fee and a copy of their Home Infusion Therapy Accreditation certificate.
Yes. To provide home infusion therapy services, a home health agency that is already billing Part B for flu shots must submit an 855B application.
Neither. If the agency submits a web application via PECOS, it then would select “Home Infusion Therapy” as the supplier type.
Infusion Pharmacy (IRX) Accreditation focuses on the pharmacy services of preparing and dispensing medication, equipment, and supplies to patients receiving home infusion therapy. Home Infusion Therapy Accreditation focuses on the education, assessment, and medication review performed by a nurse during a home visit.
No. Standards for our Infusion Pharmacy (IRX) Accreditation service are the same.
Yes. CMS requires that all locations receive an on-site survey for home infusion therapy services.
An off-site audit is conducted on a percentage of an organization’s renewing locations, based on a methodology that takes into consideration:
Home infusion therapy suppliers must have serviced three clients/patients and have one on service. In rural areas, a new home infusion therapy supplier seeking accreditation must have serviced two clients/patients.
No. The supplier does not need to be a pharmacy. The supplier must be able to meet provisions of the Social Security Act, which defines a supplier as:
A qualified home infusion therapy supplier may subcontract with a pharmacy, physician, provider of services, or another supplier to meet CMS requirements. The home infusion therapy supplier is responsible for negotiating appropriate contract terms to only assume responsibility for services related to home infusion therapy.
Payment for home infusion therapy services is a bundled payment equivalent to five hours of infusion therapy administration services in a physician’s office for each day an infusion drug is administered. Therefore, even if the clinician is in the home for only three hours, the payment is still equivalent to that for five hours. However, the home infusion therapy services provider still reports the time spent on the claim in 15-minute increments.
Yes. If the patient meets the eligibility criteria for both programs, then the agency can receive both Medicare Part A and Part B reimbursement.
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Medicare reimbursement rules now require accreditation for home infusion therapy suppliers. ACHC’s Home Infusion Therapy Accreditation program can assist providers in meeting the new requirements.
Under the new rules, agencies providing infusion nursing services to Medicare-eligible patients can bill Medicare Part B if they are accredited for home infusion therapy.
ACHC is recognized by the Centers for Medicare & Medicaid Services (CMS) as a national accreditor for home infusion therapy suppliers. This gives ACHC deeming authority to conduct surveys that meet or exceed Medicare requirements, including reimbursement rules mandated by the 21st Century Cures Act that became effective January 1, 2021.
Our Home Infusion Therapy Accreditation program looks at the education, assessment, medication review, and development of the plan of care and administration provided by a nurse in the home. ACHC staff and industry experts developed standards that conform to industry best practices, with realistic expectations for business operations.
Educational resources, including crosswalks that detail all standards changes and FAQs, are available. ACHC and Imark Billing are also offering a Home Infusion Therapy Billing Tip Sheet that includes the latest payment rates and corresponding codes.
For more information on ACHC Home Infusion Therapy Accreditation, please email customerservice@achc.org or call (855) 937-2242.