053-9 Wyo. Code R. §§ 9-10 - Fees for Home Infusion Therapy

(a) Home Infusion Therapy will be paid in accordance with the Medicare Home Infusion Therapy Fees, during quarter 4 of 2024 plus a thirty percent (30%) increase.

(b) The Division shall pay only one of the G-codes per line item date of service when one of the drugs from the applicable category is billed with the same line item date of service or a date of service within thirty (30) days prior to the G-code visit.

(i) Healthcare Common Procedure Coding System (HCPCS) code S9328-Home Infusion Therapy, implanted pump pain management infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem will be paid at Workers' Compensation Usual and Customary fee of two hundred dollars ($200.00).

(ii) The fees associated with the G-codes on the MPFSD fee file will be "a per day rate"; therefore, the units on the line should not be multiplied by the rate.

(iii) The drug remains separately payable from the G-code line item Home Infusion Therapy suppliers will report the following HCPCS G-codes associated with the payment categories for the professional services furnished in the individual's home and on an infusion drug administration calendar day.

(iv) For additional information regarding the Medicare rates and coding for these services, please visit: https://www.cms.gov/files/document/se19029.pdf and https://med.noridianmedicare.com/web/jfb/fees-news/fee-schedules/home-infusion-therapy-fees.

Notes

053-9 Wyo. Code R. §§ 9-10

Adopted, Eff. 2/2/2022. Amended, Eff. 1/13/2023. Amended, Eff. 5/10/2023. Amended, Eff. 8/18/2023. Amended, Eff. 3/22/2024. Amended, Eff. 4/3/2025.