Forum - Questions & Answers
injections for medicare patients
Medicare is not paying enough to cover cost of Rocephin 1gm injection. using code J0696 @4 units. They are paing .36 per 250mg. Can you a have a pt pay cash for injection in office if you are contracted with medicare? Do you know if Medicare's pharmacy benefit pays for it?
Something is wrong
We get $4.22 as the allowed amount from Medicare. It's April - sure it was not applied to deductible?
injection
No, you cannot have a patient pay for it when it is a covered Medicare drug. It is an injection and J codes cover this substance. It is not a self-administered drug. Rocephin may be administered intravenously or intramuscularly.
J0696 Ceftriaxone sodium injection 250 MG 0.898 as stated in the
Payment Allowance Limits for Medicare Part B Drugs, Effective April 1, 2010 through June 30, 2010.
Check with local carrier drug fee schedule.