How can an ASC receive appropriate Medicare reimbursement for providing implantable infusion pumps?
A. If an ASC is enrolled with the Medicare program as a Durable Medical Equipment (DME) supplier, the facility can bill for the infusion pump in addition to its services. The ASC must submit two separate claims, one to their Part B carrier for the use of the facility and another to their DMERC for the implantable infusion pump. However, even with this option, an ASC usually cannot recuperate its cost of providing an implantable infusion pump (and many other implantable products) for a Medicare beneficiary at this time. Medicare has been ordered by Congress to study ASC reimbursement and the feasibility of changing to a system like the one for hospital outpatient reimbursement.
