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Infusion service in clinic viable?

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  • funkmstr47
    replied
    Originally posted by Neurologo
    Usual neuro meds that can prevent unnecessary ED visits or admission. For infusion such as methylprednisolone, MS meds, few seizure meds loading. For IV push for headaches like Benadryl, Compazine, Dexamethadone. No ketamine or other magic fluids.
    This is the way our org makes money on our infusion center - but only because we have capitated payments for these individuals. Doubt it would be a moneymaker for those still under FFS.

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  • BlueCollarMD
    replied
    If Infusion makes money it is because of the margin on drugs. Thats it. Payments for administration are small in comparison. Biologics, but you need to be diligent about the price and reimbursement and make sure denials are very close to zero (compulsive preauth and collection of copays for drugs).

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  • Neurologo
    replied
    Usual neuro meds that can prevent unnecessary ED visits or admission. For infusion such as methylprednisolone, MS meds, few seizure meds loading. For IV push for headaches like Benadryl, Compazine, Dexamethadone. No ketamine or other magic fluids.

    Leave a comment:


  • Lordosis
    replied
    What are you infusing?

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  • Neurologo
    replied
    Originally posted by childay

    Are you sure there's no facility fee charge?
    This is what I am wondering.

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  • Notsobad
    replied
    One nurse can do 8-10 patients a day, more if the treatment is simple. But it will not make a profit unless you are able to have a margin on the infused product.

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  • childay
    replied
    Originally posted by Neurologo
    1 hour of IV infusion has charge code 96365 which only gets about $75 from Medicare. IV push is 96374 getting only $42. In comparison, IM or SQ injections are much higher while taking only 5-15 minutes to complete. With this level of poor reimbursement rate, it does not even cover for the equipment, rental space and RN salary. How are infusion centers surviving? Am I missing some other codes to charges for non-facility infusion?
    Are you sure there's no facility fee charge?

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  • G
    replied
    Originally posted by Neurologo
    1 hour of IV infusion has charge code 96365 which only gets about $75 from Medicare. IV push is 96374 getting only $42. In comparison, IM or SQ injections are much higher while taking only 5-15 minutes to complete. With this level of poor reimbursement rate, it does not even cover for the equipment, rental space and RN salary. How are infusion centers surviving? Am I missing some other codes to charges for non-facility infusion?
    Interesting. Can't speak to your question, but this shows that private insurance--once again--greases the wheels of healthcare! Would hate to see the Medicaid rates--oh, right, they just get sent to the ER.

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  • 8arclay
    replied
    Cash payment

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  • Neurologo
    started a topic Infusion service in clinic viable?

    Infusion service in clinic viable?

    1 hour of IV infusion has charge code 96365 which only gets about $75 from Medicare. IV push is 96374 getting only $42. In comparison, IM or SQ injections are much higher while taking only 5-15 minutes to complete. With this level of poor reimbursement rate, it does not even cover for the equipment, rental space and RN salary. How are infusion centers surviving? Am I missing some other codes to charges for non-facility infusion?
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