Professional Home Care Service

Frequently asked questions:

Is home infusion therapy covered by insurance?

Most commercial insurance plans and medical assistance plans offer coverage for home infusion services. We participate with many insurance providers and one of our Benefits Specialists will call the patient’s insurance company to research what coverage they have. The patient will then be informed of any out-of-pocket costs before therapy begins.


For information regarding coverage by Medicare, please see the section entitled
“How is home infusion covered by Medicare?”

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What insurance plans do you accept?

We participate with the following insurance plans:


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Do you accept out of network insurance plans?

Our Benefits Specialists will gladly call any insurance company to see if they offer out of network rates for payers not on the list above. The patient will then be informed of any out-of-pocket costs before therapy begins. You can reach our Benefits Specialists by calling 1-800-448-6337.

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How is home infusion covered by Medicare?

In short, the Medicare fee-for-service programs (Parts A, B, and D) do not cover most home infusion therapies. A patient’s Part D plan may cover part of the cost of the medication, but often the daily cost of administering the medication and the necessary supplies (which is called a per diem) is not covered. PHCS Benefits Specialists will research the co-pay for the medication and the per diem rate for each patient on a case-by-case basis.


In Medicare Part B, there is some coverage of certain therapies as long as they require a mechanical pump. The following information is adapted from the Report to the Congress: Medicare and the Health Care Delivery System from June 2012:

Therapy Medicare Coverage
Antibiotics Medicare Part B covers a select number of IV antibiotics, but only if they require a mechanical pump for infusion.
Medicare Part D may provide coverage of the medication, but it will not cover the cost of the supplies or nursing services associated with the home infusion.
Chemotherapy Chemotherapy services are covered if they are administered by a mechanical pump and meet certain diagnosis and medication requirements. The chemotherapy medication used most commonly by PHCS (fluorouracil) is one of the Medicare-covered drugs.
Enteral Nutrition Medicare Part B typically covers enteral nutrition therapy if the patient will require it for at least 90 days.

Please note: PHCS is currently not an in-network Medicare provider for enteral nutrition in Montgomery, Chester, or Philadelphia counties.
Hydration Not covered by Medicare.
Inotropic Therapy Inotropic therapy is covered by Medicare under a set of very specific criteria. If you have questions about Medicare coverage of inotropic therapy, please call our Billing Specialists at 1-800-448-6337.
Intravenous Immunoglobulin (IVIG) Medicare Part B may cover the cost of the medication for patients with primary immune deficiency (PID), but supplies and equipment are not covered.
Pain Management Pain management administered by a mechanical pump is covered by Medicare for the treatment of intractable pain due to cancer.
Total Parenteral Nutrition (TPN) Medicare typically provides coverage of TPN therapy for patients who will require it for at least 90 days and meet other specific criteria. Our Hospital Liaisons and Billing Specialists are available to help answer questions you may have about these criteria.

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What payment types do you accept?

We are able to accept payment in the form of cash, check, and credit card (Discover, MasterCard, and Visa).

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Do you offer payment plans?

We understand that unexpected medical costs can squeeze any budget. PHCS is strongly committed to providing compassionate, patient-centered care and will discuss payment plan options with patients concerned about the cost of their home infusion therapy.

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