Remicade Billing

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Veteran Member

Date Joined Jul 2006
Total Posts : 2105
   Posted 3/24/2009 6:51 AM (GMT -6)   
Anyone get billed as an office visit for this? Curious on billing approaches.
Proctitis DX 1999, Pancolitis DX 2008
Lialda 1 day
Golimumab study (100mg every 4 weeks)
Vitamin E Enemas as needed

Regular Member

Date Joined Sep 2008
Total Posts : 153
   Posted 3/24/2009 9:11 AM (GMT -6)   
I am not billed for this at all. I believe the office runs it through to the insurance company as an office proceedure, and since I get it done in the office (instead of a hospital, etc), my insurance pays 100%. I would suggest checking with your insurance company, and if needed, call your doctors office and ask them how they bill for remicade infusions.

Good luck!
Diagnosed w/IBS: Oct. 2006
Diagnosed w/UC: Jan. 2007 (proctitis), July 2008 (pancolitis)
Medications: Canasa (helped the first flare when it was just proctitis); Rowasa enemas (did not help as the following colonoscopy confirmed pancolitis); Lialda (2 pills in the morning, 2 pills in the evening, soon to be 2 pills in the morning only once I'm off steriods); Prednisone; Protonix (only took while on prednisone); Remicade infusions, started at 5mg/kg, increased in March to 7.5mg/kg (started Aug 2008 - 6 infusions so far, next infusion on 4/30 continuing every 8 weeks); Zyrtec-D (for allergies); Toprol (a generic form, 25 mg, for a rapid heart rate)
Supplements: Women's One-a-day multi-vitamin; Super B-complex w/vitamin C, Iron supplements, Omega-3 Fish Oil (coated, not sure how much except one soft-gel daily), Aloe Vera supplement (currently taking one daily, will increase to two soon)
Diet: Spinach and Sunflower seed butter diet (starting 3/22/09)
Current Status: Reached remission for a few weeks in October 2008, but symptoms returned after I allowed myself to enjoy wine again.... gave up wine and have not been in full remission again yet. 

Regular Member

Date Joined Nov 2008
Total Posts : 360
   Posted 3/24/2009 10:00 AM (GMT -6)   
I have a $3,000.00 out of pocket expense per year. Once I meet this, then Blue Cross pays for the infusions. Each infusion is between 9,000 and 10,000. Every 3 or 4 infusions, the doctor actually comes into the room, shakes my hand and asks me how I feel. He charges an additional office visit for that. I am very lucky to have this insurance, otherwise I could not afford this medication. When he charges for the office visit, I have to pay 25.00.
Presently on: 600 mg. Remicade every 4 weeks
                   Venofer infusion every 4 weeks
                   B12 every 4 weeks              
                   15 mg. Methotrexate/injection weekly
                   12 Asacol daily
                   10 mg. Celexa daily

Elite Member

Date Joined Mar 2003
Total Posts : 10407
   Posted 3/24/2009 11:52 AM (GMT -6)   
In Austin, my GI had an infusion center. It was billed as an office procedure, and I paid only my co-pay.

Since I moved, I get Remi at the hospital infusion center. It's billed from the hospital, so my deductible kicks in. I have a maximum of $2000 then it is covered 100%.

Interestingly, the infusion center billed about $9000. The hospital bills about $13000. My insurance company pays the same to both - about $5500.

Like Nor_TX, I could never afford Remi without insurance. I doubt many people could. Sometimes I actually feel a little guilty for how much it's costing my former employer, which is self-insured.
Moderate to severe left-sided UC (21 cm) diagnosed 2001.
Avascular necrosis in both shoulders is my "forever" gift from Entocort.
Colazal,  Remicade, Nature's Way Primadophilus Reuteri. In remission since April, 2006.
"My life is an ongoing medical adventure"
Co-Moderator UC Forum
Please remember to consult your health care provider when making health-related decisions.

Mamas Boys
Veteran Member

Date Joined Oct 2005
Total Posts : 1460
   Posted 3/24/2009 12:08 PM (GMT -6)   
My docs office is actually a licensed infusion center.  Mine gets billed on insurance as chemotherapy.  My plan is 80/20 and it gets covered a 80%.  I usually pay about $500 per infusion after the insurance.
Mamas Boys
Colazal, Azathioprine, Remicade
Culturelle, MultiVitamin, Folic Acid, Viactiv
Status: Remission!!

Regular Member

Date Joined Sep 2008
Total Posts : 91
   Posted 3/24/2009 6:11 PM (GMT -6)   
I go to a hospital infusion center also so it gets billed as chemo. The cost that gets billed to my insurance company is $22000! I guess costs have gone up because it used to be $19000. I have a $2000 out of pocket so after the 2nd infusion of the year my insurance covers it 100%.
31 year old female diagnosed with UC (entire colon) Feb 2008
(4) 400mg Asacol 3x a day
Remicade 10mg/kg every 8 weeks
Omega 3 supp, calcium supp

Veteran Member

Date Joined Feb 2005
Total Posts : 2103
   Posted 3/24/2009 8:07 PM (GMT -6)   
I went to the hospital for it as well. I don't remember how we were billed but it for sure wasn't as an office visit.
20 year old medical technology/biology student
Remission since January/April 2006
4 400mg Asacol 2x daily, 10mg Elavil, 75mg Effexor XR for GAD, ortho lo

"Life is what happens when you are busy making other plans"
John Lennon

New Member

Date Joined Jul 2008
Total Posts : 15
   Posted 3/24/2009 11:02 PM (GMT -6)   
I actually go to an infusion center and it only costs me a $10.00 copay and I have Blue Cross Blue Shield. I am very lucky that this is what I have to pay. It is billed to the insurance company as chemotherapy.
23 yr. old female
diagnosed age 15, current meds: 100 mg azathioprine, iron, remicade every 8 weeks
have taken: asacol,colazal, prilosec, prenisone, rowasa + cortisone enemas, flagyl + vancomycin for c-diff
hospitalized three times: 2002 April (2 weeks) 2003 December (1 week) 2006 (1 week), have had pick line,
have had 3 colonoscopies, had blood transfusion Feb 2008

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