MLN Matters Article: Billing Medicare Part B for Insulin with New Limits on Patient Monthly Coinsurance

Starting July 1, 2023, the Part B coinsurance for a month’s supply of insulin used in an insulin pump covered under the DME benefit can’t exceed $35 (as required by Section 11407 of the Inflation Reduction Act). In addition, the Part B deductible won’t apply for the insulin starting July 1, 2023. This provision of the law applies only to patients who use insulin delivered through insulin pumps covered under the Part B benefit for DME.

To read the full MLN Matters article which includes information related to affected suppliers and how to bill for insulin supplies with the two new modifiers, click on the link below or paste the following into your Internet browser:  MLN4443820 - Billing Medicare Part B for Insulin with New Limits on Patient Monthly Coinsurance (cms.gov)

Post Date: 02/16/2023