For many patients receiving recurring infusion therapy, the possibility of receiving treatment at home sounds appealing.
No driving to an infusion center.
No parking.
No spending additional time traveling before and after a several-hour infusion.
Instead, an experienced nurse comes to the patient.
But home infusion is not appropriate for every patient, medication, or clinical situation.
Eligibility depends on several factors, including:
- Physician’s prescription
- Medication
- Diagnosis
- Medical stability
- Previous infusion experience
- Risk of adverse reactions
- Required level of monitoring
- Home environment
- Nursing availability
- Insurance coverage
CMS defines home infusion therapy as the intravenous or subcutaneous administration of certain drugs or biologicals to an individual at home and recognizes that home infusion includes professional services, training, education, and monitoring.
Mercy Infusion coordinates /home-infusion/ throughout California for eligible patients.
Interested in Home Infusion?
Our team can review your physician’s prescription, insurance requirements, and treatment needs to help determine whether home care may be an option.
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Requirement 1: A Physician Must Prescribe the Therapy
Home infusion begins with a physician-directed treatment plan.
The order may specify:
- Medication
- Dose
- Frequency
- Infusion rate
- Treatment duration
- Premedications
- Required laboratory monitoring
- Nursing instructions
- Treatment setting
The infusion provider does not independently decide that a patient should begin a medication.
Requirement 2: The Medication Must Be Appropriate for Home Use
Not every infusion therapy can be safely or practically administered at home.
Factors include:
- Medication properties
- Infusion protocol
- Monitoring requirements
- Risk of serious reaction
- Required equipment
- Stability and storage
- Product labeling
- Physician instructions
Home therapies may include selected:
- IVIG treatments
- SCIG
- Antibiotics
- Hydration
- Parenteral nutrition
- Specialty biologics
- Other physician-prescribed therapies
Availability depends on the specific medication and clinical situation.
Requirement 3: The Patient Should Be Medically Stable
Home infusion is intended for patients who can be treated safely outside a hospital-level environment.
A patient may be less appropriate for home care when experiencing:
- Unstable vital signs
- Severe respiratory symptoms
- Rapid neurologic deterioration
- Serious active infusion reactions
- A medical emergency
- A need for hospital-level monitoring
The treating physician and clinical team determine the appropriate level of care.
Requirement 4: Monitoring Needs Must Be Appropriate for the Home
Every infusion requires some level of monitoring.
During a home visit, a nurse may:
- Review current symptoms
- Measure vital signs
- Assess venous access
- Administer medication
- Monitor for reactions
- Adjust the infusion according to the physician’s order
- Provide education
- Document treatment
- Communicate concerns to the clinical team
However, the home does not have the same immediate resources as a hospital.
A patient who requires intensive observation may be better suited for an /infusion-suite/ or hospital setting.
Requirement 5: Previous Infusion Experience May Matter
Some patients begin therapy in a supervised clinical environment and transition home after demonstrating that they tolerate treatment.
This may be particularly relevant when:
- The medication is new
- The patient has never received an infusion
- The product carries significant reaction risk
- The physician wants closer first-dose monitoring
A first dose does not always have to occur in a facility. The decision is medication- and patient-specific.
Requirement 6: The Patient Needs Appropriate Access
Many home therapies require reliable venous access.
This might involve:
- Peripheral IV
- PICC line
- Central venous catheter
- Implanted port
- Another prescribed access device
SCIG does not require intravenous access because the medication is infused under the skin.
The appropriate access method is determined by the physician and clinical team.
Requirement 7: The Home Environment Must Be Suitable
Home infusion turns part of the home into a temporary treatment space.
A suitable environment may require:
- Clean treatment area
- Reliable electricity
- Running water
- Appropriate lighting
- Safe medication storage
- Refrigeration when required
- Space for supplies
- Safe access for the nurse
Medication and supplies must be stored according to pharmacy instructions.
That may include:
- Temperature requirements
- Protection from light
- Proper refrigeration
- Safe sharps disposal
- Keeping equipment away from children or pets
Requirement 8: The Patient or Caregiver Must Be Able to Participate
Depending on the therapy, the patient or caregiver may need to understand:
- Medication storage
- Equipment
- Access-site care
- Symptoms requiring attention
- Emergency procedures
- Delivery schedules
- Who to contact with questions
Some treatments require a nurse for every infusion.
Others, such as certain SCIG therapies, may allow trained patients to self-administer.
Requirement 9: Nursing Must Be Available
Home infusion relies on appropriately trained professionals.
Nursing availability can depend on:
- Geographic location
- Treatment schedule
- Medication
- Duration
- Required specialty experience
The preferred appointment time cannot always be guaranteed.
Requirement 10: Insurance Must Authorize Home Infusion
Even when home infusion is clinically appropriate, coverage must be verified.
A plan may require:
- Prior authorization
- In-network pharmacy
- In-network nursing
- Specific medication
- Site-of-care approval
- Documentation supporting medical necessity
Some insurers actually prefer home infusion for appropriate patients because it can avoid hospital outpatient utilization.
Others may impose specific network or site requirements.
Mercy verifies benefits through the /how-it-works/ process before treatment whenever possible.
Who May Be a Strong Candidate?
Home infusion may be particularly appealing for patients who:
- Are medically stable
- Need recurring therapy
- Have tolerated treatment
- Have difficulty traveling
- Live far from a facility
- Have mobility challenges
- Prefer privacy
- Have an appropriate home environment
- Can safely receive the medication outside a hospital
Age alone does not automatically determine eligibility.
Older adults can receive home infusion when clinically appropriate, and pediatric patients may also receive certain therapies at home under the appropriate treatment plan.
Who May Be Better Suited for an Infusion Center?
A patient may benefit from a supervised clinical setting when:
- Close monitoring is required
- A first dose warrants observation
- There is a history of significant infusion reactions
- Medical status is unstable
- The medication requires facility-based administration
- The home environment is unsuitable
- Insurance requires a facility
- The patient simply prefers a clinical setting
Patients can compare both options in /home-infusion-vs-infusion-center/.
Is IVIG Available Through Home Infusion?
Yes, eligible patients may receive /ivig-therapy/ at home.
The decision may depend on:
- Diagnosis
- IVIG product
- Dose
- Infusion rate
- Previous tolerance
- Kidney or clotting risk factors
- Reaction history
- Medical stability
- Insurance authorization
Some patients receive IVIG in an infusion suite first and move home later.
What Happens Before Home Infusion Starts?
- Referral Received
Mercy reviews the physician’s prescription and clinical documentation.
- Benefits Verification
Insurance coverage and site-of-care rules are reviewed.
- Prior Authorization
Required clinical documentation is coordinated.
- Clinical Review
The team considers whether the treatment can be safely provided at home.
- Financial Review
Potential patient responsibility and /copay-assistance/ resources may be explored.
- Medication and Supplies
The pharmacy coordinates delivery and storage instructions.
- Nursing
A qualified nurse is scheduled.
- Treatment Begins
The nurse follows the physician-directed care plan and monitors the patient.
Find Out Whether Home Infusion May Be an Option
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Frequently Asked Questions
Can anyone choose home infusion?
No. The therapy must be clinically appropriate, prescribed by a physician, and compatible with the patient’s medical condition and home environment.
Is home infusion safe?
Home infusion can be safe for appropriately selected patients when coordinated by qualified pharmacy, nursing, and clinical professionals.
Does a nurse stay throughout treatment?
For nurse-administered therapies, nursing involvement depends on the medication, protocol, physician’s order, and insurance authorization.
Can IVIG be given at home?
Yes, many stable patients receive IVIG at home when the physician and clinical team determine that the setting is appropriate.
Do I have to receive my first infusion in a clinic?
Not necessarily. First-dose requirements depend on the treatment and patient.
Does Medicare cover home infusion?
Medicare coverage depends on the specific medication, benefit, clinical circumstances, and applicable coverage rules. Patients should have benefits verified before treatment.
Can I switch from an infusion center to home?
Potentially. A transition may require physician approval, clinical review, updated orders, nursing coordination, and insurance authorization.
Home Infusion Is About More Than Convenience
Home infusion can make treatment significantly easier for appropriate patients, but convenience is only one factor.
The primary question is whether the patient can receive the prescribed therapy safely and appropriately at home.
Mercy Infusion works with patients, physicians, pharmacists, nurses, and insurers to evaluate those requirements and coordinate the treatment setting.
About the Author
April Cable, Senior Director of Operations
April Cable has more than 35 years of specialty pharmacy experience spanning operations, reimbursement, billing, insurance coordination, and patient access.
Home infusion eligibility, insurance coverage, nursing availability, treatment timing, and financial assistance cannot be guaranteed.
