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Medicare injectables

kathymoon

Guest
Messages
84
Location
Lansing, Michigan
Best answers
0
I am hoping someone can help me with this. We are giving Avonex injections to a Medicare patient. Medicare is not reimbursing us for the cost of the injectable (about $40.00 less than cost). Does anyone know how to go about getting paid at least for the amount we paid? Does it help to note the info on the claim or do we have to appeal after payment? Any suggestions will be appreciated. :confused:

Thanks,
Kathy
 

lch

Networker
Messages
39
Location
Nashville, TN
Best answers
0
Have you tried to fill the injection through the patient's Part D plan? You are only going to get paid what Medicare allows for that drug.
 

squallks

Guest
Messages
5
Best answers
0
We found the same thing. What our practice decided to do, was have the pateints use there Medicare D benefits to pick up the drug from the pharmacy. They comes in weekly for the injection and bring the drug with them. All we bill is the IM admin fee, thus reducing our loss. When billing the admin only, it is still necessary the drug administered in Box 29.
 
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