Price difference for patient between outpatient office injection versus ASC injection?

[DoctorInScrubs]

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What is the typical out-of-pocket cost for patients between doing injections (ESI, MBB, RFA, SIJ, SCS trial) at a surgery center versus an outpatient office? Do you do your procedures at an outpatient office or an ASC?

1) Many of my patients want to know their out-of-pocket cost when deciding where to get their injections done (outpatient v ASC). I would like to get a general gist of what expectations to set for patients regarding the difference in out-of-pocket cost for them.
2) Certain other patients I will push towards the surgery center due to difficulty positioning etc. I want to know how much of a financial burden this places on my patients.

 

[pmrmd]

Private insurances have different facility copays. Whatever that amount is, its more expensive than an office copay.

Medicare doesn't matter.

I do everything I can in office and take sedation cases or procedures that require a facility SOS to the ASC.

 

[Agast]

Cash pay facility fee is $500 at our ASC

Then the additional cost they charge for the procedure I’m doing

 

[Ducttape]

its difficult to make a blanket statement about copays.

for me, the issue is that insurance companies dictate what copays are required, so every patient is different.

in addition, some insurers make no difference between office and ASC deductibles.

medicaid programs - $0.

private insurance in this area - ive heard $50-$450.

have the patient ask the ASC.

 

[callmeanesthesia]

I think there is a Medicare issue where the copay caps out in the hospital but not at an ASC so many higher dollar procedures are actually cheaper for patients at a hospital even though Medicare pays more.

 

[IYKYK]

In general, Office-based procedures are cheaper for patients. Patients either have to pay a copay or less toward their deductible in the office because there's no facility fee.

 

[SSdoc33]

We are all experts and can’t really answer this question. That should tell you something

 

[Agast]

Well, you can look at the Medicare reimbursement table and see the professional fee difference and the facility fee per procedure. I don’t have the latest ASIPP data but it gives you a good idea of a base.

 

[DoctorInScrubs]

Interesting good to know it is very variable across insurances. I guess I'll have to look at the numbers for Medicare to get a gist of it.