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Prolia Injection or Infusion and how it effects billing
Osteoporosis & Bone Health | Last Active: Mar 28 9:37am | Replies (20)Comment receiving replies
I ran into this confusing issue as well. Are you on Medicare?
I am no longer on Prolia but thought perhaps the method 'label' might have something to do with how it is billed for Medicare coverage and affecting what is actually paid to the provider/and the amount of patient responsibility (or paid by supplemental insurance.)
An 'injection' might be handled under Part D and an 'infusion' might be handled under Medicare Part B.
Anyone have any thoughts about this and whether patient responsibility is impacted?
Replies to "I ran into this confusing issue as well. Are you on Medicare? I am no longer..."
I had several Prolia injections. They were administered in the doctor's office and were paid by Medicare Part B.
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I am on Medicare. It was strange because both the doctor and the infusion center called it an infusion but neither explained what it entailed. In fact, the doctor told me it was be a shot in his office. The center believes doctors don’t get reimbursed so they refer the shots out.