InfuSystem Pain Management Infusion Pumps To Receive Separate Medicare Payment Under NOPAIN Act Starting January 1, 2026
Ambulatory Infusion Pumps used in Pain Management Business by InfuSystem to Receive Separate Payment Under NOPAIN Act Starting January 1, 2026
Rochester Hills, Michigan, December 10, 2025 - InfuSystem Holdings, Inc. (NYSE:INFU) ("InfuSystem" or the "Company"), a leading national health care service provider, facilitating outpatient care for durable medical equipment manufacturers and health care providers, announced today that the Centers for Medicare and Medicaid Services ("CMS") has added two of the electronic infusion pumps currently utilized by the Company within its Pain Management services business to the list of qualifying products for separate payment in conjunction with the Non-Opioids Prevent Addiction in the Nation ("NOPAIN") Act. The NOPAIN Act mandates that CMS provide separate payment for qualified non-opioid treatments through December 31, 2027 when provided with a covered surgical procedure. This payment may now be available to InfuSystem's current and potential Pain Management customers for certain patients. This initiative is part of a broader strategy by CMS to combat the opioid crisis by promoting safer pain management alternatives. The two pumps are the CADD-SolisTM manufactured by ICU Medical, Inc., and Eitan Medical's SapphireTM pump.
Carrie Lachance, InfuSystem CEO, commented on the decision, stating, "We are very glad to see that CMS has expanded upon its initial decision from last year and acknowledged that electronic infusion pumps such as the CADD-SolisTM and the SapphireTM are effective non-opioid options for reducing opioid use after surgery. We will continue to work in partnership with healthcare providers and device manufacturers to advocate for proven non-opioid treatments for pain."
Ms. Lachance continued, "This rule change, together with the approved reimbursement, has the potential to act as a catalyst for volume growth in our Pain Management business by encouraging health care providers to consider adding our service to their formulary. However, our forward outlook will continue to be tempered until we gain further understanding surrounding the requirements for reimbursement and until we see adoption by our current and potential customers. We will continue to work closely with these customers on this opportunity and will provide updates should we see any material new developments."
The New Rule
On November 25, 2025, CMS issued its final Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ASC) Payment System rule for 2026. This rule, effective January 1, 2026, implements the NOPAIN Act that mandates separate Medicare payment for qualifying non-opioid drugs and devices.
The NOPAIN Act, passed as part of the Consolidated Appropriation Act of 2023, aims to increase patient access to non-opioid drugs and devices used to manage pain in Hospital Outpatient (HOPD) and ASC settings by providing additional Medicare reimbursement for qualifying non-opioid items.
In the final rule, CMS confirmed that the CADD-SolisTM infusion pump manufactured by ICU Medical, and used by InfuSystem for the majority of its Pain Management services business, and Eitan Medical's SapphireTM Infusion Pump, meet qualifying requirements, making them eligible for separate payment under the NOPAIN Act. HOPDs and ASCs that use these products will receive separate Medicare reimbursement in addition to the related APC payments beginning January 1, 2026.
Both the CADD-SolisTM infusion pump and the SapphireTM Infusion pump received a unique, brand-specific Healthcare Common Procedure Coding System (HCPCS) code eligible for separate payment in the HOPD and ASC settings. This decision by CMS is a pivotal step towards enhancing access to clinically proven non-opioid treatments for Medicare beneficiaries in HOPD and ASC settings.
The payment limitation calculated and published by CMS is up to $1,997.16. The new unique HCPCS code C9815 for the CADD-SolisTM Infusion pump and C9811 for Eitan's SapphireTM pump can be used on claim submissions for services rendered beginning on January 1, 2026.
The NOPAIN Act mandates that CMS provide separate payment for qualified non-opioid treatments through December 31, 2027 when provided with a covered surgical procedure. The CADD-SolisTM and SapphireTM infusion pumps will now accompany other ambulatory infusion pain pumps previously included under this policy, which aims to reduce reliance on opioids in postoperative care. CMS will review and approve eligible products on an annual basis during the 3-year program. This initiative is part of a broader strategy by CMS to combat the opioid crisis by promoting safer pain management alternatives.