Yes, Medicare Part B covers IVIG (intravenous immune globulin), but only for specific diagnoses and settings. The most straightforward coverage is for primary immune deficiency diseases (PIDD), where Part B pays for the drug itself whether you receive it in a doctor’s office, hospital outpatient department, or at home. For other conditions, coverage depends on the clinical situation and whether standard treatments have already been tried.
What Part B Covers for Primary Immune Deficiency
If you have a diagnosed primary immune deficiency disease, Part B covers IVIG in all treatment settings. You can receive it at your doctor’s office, a hospital outpatient department, or in your own home. For home administration specifically, your treating physician must determine that receiving IVIG at home is medically appropriate for you.
The IVIG product itself must be an FDA-approved pooled plasma derivative indicated for treating primary immune deficiency. Not every immune globulin product qualifies. CMS specifically excludes certain product codes from this benefit because they aren’t indicated for primary immune deficiency.
Starting January 1, 2024, Medicare made the home IVIG benefit permanent with a bundled payment that covers services, supplies, and accessories needed to administer the infusion at home. For 2026, that bundled payment rate is $442.19 per infusion day, paid separately from the cost of the drug itself. This can include items like tubing, catheters, and IV poles, though it doesn’t necessarily include an infusion pump.
Coverage for Other Conditions
Part B also covers IVIG for a group of autoimmune blistering skin diseases, including pemphigus vulgaris, pemphigus foliaceus, bullous pemphigoid, mucous membrane pemphigoid, and epidermolysis bullosa acquisita. These must be confirmed by biopsy, and coverage kicks in only when you meet one of three criteria: conventional treatments have failed, conventional treatments are contraindicated for you, or your disease is progressing so rapidly that standard medications can’t work fast enough on their own.
For these blistering conditions, IVIG is approved only as short-term therapy, not as ongoing maintenance treatment. The expectation is that IVIG bridges the gap while conventional treatments take effect.
When IVIG is administered in an outpatient hospital or physician’s office for any covered diagnosis, Part B treats it like any other physician-administered drug. The facility bills Part B directly, and you pay your standard cost share.
What You’ll Pay Out of Pocket
For home IVIG equipment and supplies, you typically pay 20% of the Medicare-approved amount after meeting the Part B annual deductible, which is $257 in 2025. The same 20% coinsurance generally applies to IVIG administered in outpatient settings. Since IVIG is an expensive therapy, that 20% can still be substantial. If you have a Medigap (supplemental) policy, it may cover some or all of that coinsurance.
Documentation Your Doctor Must Provide
Medicare requires detailed documentation before it will pay for IVIG. Your physician needs to submit a history and physical exam from the past 12 months, along with orders specifying the dose, frequency, and route of administration. Those orders must be no more than 30 days old at the time of each infusion. Lab results and procedure test results supporting your diagnosis are also required, and your weight in kilograms must be documented before each infusion because dosing is calculated by body weight.
For conditions beyond primary immune deficiency, the documentation must also show that prior conventional therapies have failed or explain why they’re contraindicated. After the first infusion, follow-up orders need to include notes on how you responded to previous treatments. Claims submitted without proper diagnostic codes or supporting evidence are denied as not medically necessary.
Part B vs. Part D for IVIG
The distinction between Part B and Part D coverage for IVIG comes down to where and why you’re receiving it. Part B covers IVIG when it’s administered by a healthcare provider in an outpatient setting (a doctor’s office or hospital outpatient department) or in your home for primary immune deficiency. Part D, Medicare’s prescription drug benefit, generally covers drugs you pick up at a pharmacy and self-administer.
For most people receiving IVIG, Part B is the relevant benefit because the drug requires professional administration through an IV line. If you’re currently receiving IVIG at a hospital or clinic, that’s already being billed under Part B. The home IVIG benefit also falls under Part B, but it’s structured differently: the drug payment goes through one channel while the supplies and services payment goes through a durable medical equipment supplier.
How Home Infusion Services Work
If you’re eligible for home IVIG under the primary immune deficiency benefit, a durable medical equipment (DME) supplier enrolled with Medicare handles the billing for your infusion supplies and related services. Medicare pays the supplier a single bundled rate per infusion day, covering everything needed to safely administer the drug at home. This can include nursing visits, caregiver training, and patient monitoring.
One important detail: if you’re already receiving care under a Medicare home health episode, you aren’t eligible for the separate home IVIG demonstration or bundled payment because those administration services are already covered through your home health benefit. Your home health agency would handle the infusion services in that case.