The Latest Changes to Nebulizer Medications
In March, the DME Program Safeguard Contractors (DME PSCs) released the following coverage changes in a nebulizer draft LCD:
• Payment for levalbuterol will be based on the allowance for albuterol.
• Payment for DuoNeb will be based on the allowance for separate unit dose vials of albuterol and ipratropium.
• Coverage will be eliminated for the following nebulizer drugs based on inadequate support in the medical literature for administration using a DME nebulizer: amikacin, atropine, beclomethasone, betamethasone, bitolerol, dexamethasone, flunisolide, formoterol, gentamicin, glycopyrrolate, terbutaline and triamcinalone. Coverage will be limited to these drugs: acetylcysteine, albuterol, budesonide, cromolyn, dornase alpha, iloprost, ipratropium, isoetharine, isoproterenol, levalbuterol, metaproterenol, pentamidine and tobramycin.
• Maximum milligrams/month for budesonide were defined.
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