Wiki Injection Medications

[jflynn]

Does anyone know how to figure the cost of billing out injection medications ie. J1885 Toradol 40mg for $----? I have never had to figure this before so I could definitely use some guidance.

 

[shomeyj12]

Medicare has a yearly injection fee schedule that will give you a baseline per mgs. https://www.cms.gov/Medicare/Medica...s/McrPartBDrugAvgSalesPrice/2017ASPFiles.html

 

[jonique.dietzen]

We charge based on the cost to the clinic for the medication.

J1885 - Injection, ketorolac tromethamine, per 15 mg

We would figure out the cost to the clinic for 15 mg, and that is the amount that we would charge per unit.

Jonique Dietzen, CPC

 

[mhstrauss]

We charge based on the cost to the clinic for the medication.

J1885 - Injection, ketorolac tromethamine, per 15 mg

We would figure out the cost to the clinic for 15 mg, and that is the amount that we would charge per unit.

Jonique Dietzen, CPC

I agree with this, making sure that the amount you come up with includes tax. Also, make sure this number is above the contracted rate for all of your payers, otherwise you'll be shorting yourself on possible reimbursement. One common formula is 10-20% above your highest contracted rate.

HTH!

 

[jflynn]

Thank you for the information! I really appreciate you taking the time to assist me.

 

[travelrunner@msn.com]

Cpc-a

We charge based on the cost to the clinic for the medication.

J1885 - Injection, ketorolac tromethamine, per 15 mg

We would figure out the cost to the clinic for 15 mg, and that is the amount that we would charge per unit.

Jonique Dietzen, CPC

Hi,
Do you send an inquiry to the Provider for documentation of the injection site, i.e. left vs right and if IM, which muscle?