Page 299 - Medicare Benefit Policy Manual

professional or technical personnel. Additionally, the skilled professional must only
furnish services within the scope of his/her practice.

No payment may be made under Medicare Part A or Part B for any expenses incurred for
items or services which are not reasonable and necessary for the diagnosis or treatment of
illness or injury or to improve the functioning of a malformed body member.

The services provided under the home infusion therapy services benefit are distinct from
those required and paid under the DME benefit and may include, but are not limited to,
the following:

- Training and education on care and maintenance of vascular access devices:
o Hygiene education
o Instruction on what to do in the event of a dislodgement or occlusion
o Education on signs and symptoms of infection
o Teaching and training on flushing and locking the catheter
- Dressing changes and site care
- Patient assessment and evaluation:
o Review history and assess current physical and mental status, including
obtaining vital signs
o Assess any adverse effects or infusion complications
o Evaluate family and caregiver support
o Review prescribed treatment and any concurrent oral and/or over-the-
counter treatments
o Obtain blood for lab-work
- Medication and disease management education:
o Instruction on self-monitoring
o Education on lifestyle and nutritional modifications
o Education regarding drug mechanism of action, side effects, interactions
with other medications, adverse and infusion-related reactions
o Education regarding therapy goals and progress
o Instruction on administering pre-medications and inspection of medication
prior to use
o Education regarding household and contact precautions and/or spills
- Remote monitoring services
- Monitoring services:
o Communicate with patient regarding changes in condition and treatment
plan
o Monitor patient response to therapy
o Assess compliance

Some of these services are further described in sections 320.6.1 and 320.6.2 of this
chapter.
320.6.1 - Home Infusion Therapy Services Training and Education
(Rev. 10547, Issued: 12-31-20, Effective: 01-01-21, Implementation: 01-04-21)