Infusion Therapy
Infusion therapy is when medication is administered through a needle or catheter and is often prescribed when someone’s condition is so severe that oral medication cannot effectively treat the condition, such as cancers, blood disorders, autoimmune diseases, and infections.
The cost for infusion therapy varies across settings:
- Clinics – Clinic infusions may take place in a dedicated center or a physician’s office.
- Homes – Patients may choose to have their infusion therapy administered in their home by registered nurses and pharmacists, directed by a physician. This service may be referred to as an Ambulatory Infusion Suite (AIS) of the home infusion therapy provider.
- Hospitals – Infusion services can be delivered in an inpatient or outpatient setting, including cancer centers and ambulatory infusion clinics.
- Ambulatory Surgery Centers (ASC) – Healthcare settings that provide same-day surgery care, including diagnostic and preventive procedures, can also administer infusion therapy services.
- Mixed Mode – Combination of settings.
How to Use This Report
We calculated the median payments for one unit of a drug and its administration via needle in an IV, for four high cost, high utilization infusion therapy services:
Code | Drugs | Brand Names | Use |
---|---|---|---|
J1569 | Gammagard Liquid Injection (500 mg) | Gammagard Liquid® | Protects against infection in immune system disorders |
J1745 | Infliximab Injection | Remicade® | Minimizes inflammation |
J3010 | Fentanyl Citrate Injection | Treats severe pain | |
J7120 | Ringers Lactate Infusion (up to 1000 cc) | Restores fluids and electrolytes |
Methodology
The display shows median payments statewide across all insurers for infusion therapy services administered from April 1, 2022 – March 31, 2023, using data from MHDO's All-Payers Claims Database (APCD). Information on the uninsured or public payors Medicare and Medicaid (MaineCare) are not included.
Regardless of your health insurance, talk with your health care provider to see if receiving infusion therapy in a less expensive setting is an option.