Reimbursement for outpatient parenteral antibiotic therapy: update.
Reimbursement policies of third-party payers, including Medicare, reflect a variety of coverage patterns. For a limited group of Medicare patients who are, in Medicare terms, confined to home and require skilled and intermittent care, Medicare Part A covers home care services deemed medically necessary by a physician. Medical equipment and supplies may be included under this coverage. Medicare Part B covers physician services, laboratory tests, and drugs used by out-patients. The latter must be administered directly by a physician or by an employee of a physician with direct supervision by a physician. These restrictions have, in general, prevented reimbursement by Medicare for iv antibiotic therapy in the home. Medicaid, Blue Cross/Blue Shield, various commercial insurers, and health maintenance organizations usually cover iv antibiotics, but in many cases prior approval is necessary for coverage.
Balinsky
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New School for Social Research, New York, New York 10011.
D000553:Ambulatory Care / Q000191:economics*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D006701:Home Nursing; D006801:Humans; D007263:Infusions, Parenteral; D007349:Insurance, Health, Reimbursement; D008484:Medicaid; D016344:Medicare Part A; D016345:Medicare Part B; D012646:Self Administration; D014481:United States
D000900:Anti-Bacterial Agents