New Medicare Billing Code Targets Hospital Avoidance for Heart Failure

Starting October 1, 2026, the new code, J1946, permits healthcare providers to bill for the drug and its accompanying Infusor device under the Medicare Part B medical benefit. This classification is significant because it covers the preparation and placement of the device while the patient is still under a physician's care, rather than relegating the treatment to pharmacy-based dispensing.

Designed for patients at imminent risk of hospitalization due to fluid overload, the device features a "Travel Home" function. This allows clinical staff to set up the infusion system before discharge, enabling patients to return home to complete their treatment. According to Dr. Sean Collins of Vanderbilt Health, this pathway offers a practical solution to emergency department overcrowding and prolonged boarding by safely transitioning patients to outpatient diuresis. SQ Innovation, the developer of the therapy, expects the coding update to better align clinical practice with the logistical realities of managing chronic heart failure.