Toradol Reimbursement

[Guest guest]

I'm a bit confused - again.

I'm trying to set my pricing on our fee schedule for Toradol.

The Toradol was $23.44 for 10 vials of 30mg/ml - each 1cc, I believe.

So I guess each 30mg/vial is $2.34 or $1.17 per 15mg increment -- this

doesn't include shipping costs, etc.

I believe the J1855 is per 15mg dose given.

Of course, one gets (possibly) some monies for the injection, but...do I

basically lose money on the actual cost of the medicine.

I'm not sure how to read the CHP+ fee schedule (it's a Colorado program a

step up from Medicaid) , but it is...

Code Modifier

(if applicable) Description Non Facility Fee Fee Flat Fee

J1885 Ketorolac tromethamine inj $0.00 $.00 $0.54

Does that mean we lose $1.17 - $0.54 = $0.63 per 15mg dose ?

A medicare site somewhere else says...

I'm a bit confused - does that mean I'm losing money every time I give it

-- at least to patients with these insurances?

For those out of my region -- how much have you been getting reimbursed for

the J1885?

thanks

Locke, MD

[Guest guest]

,

I too have noticed this " bleeding point. " Toradol is the only injectable pain medication I keep at my office (I actually have a sign that states " No narcotics kept at this office " on my front door.)

I have one patient that toradol takes care of her back pain that, up until she saw me, was only controlled with narcotics. She gets about one shot a month. I gave her a prescription to pick up the injectable toradol at a local pharmacy and she brings it in. I just charge the visit code and she provides the medication. I mainly use it for migraines and kidney stones, and just loose the money on those patients.

It does not seem right at all that we can not recoup the actual cost, but that appears to be how it is. Grrrr...

Durango, CO

I'm a bit confused - again.I'm trying to set my pricing on our fee schedule for Toradol.The Toradol was $23.44 for 10 vials of 30mg/ml - each 1cc, I believe.So I guess each 30mg/vial is $2.34 or $1.17 per 15mg increment -- this

doesn't include shipping costs, etc. I believe the J1855 is per 15mg dose given.Of course, one gets (possibly) some monies for the injection, but...do Ibasically lose money on the actual cost of the medicine.

I'm not sure how to read the CHP+ fee schedule (it's a Colorado program astep up from Medicaid) , but it is...Code Modifier(if applicable) Description Non Facility Fee Fee Flat FeeJ1885 Ketorolac tromethamine inj $0.00 $.00 $0.54 Does that mean we lose $1.17 - $0.54 = $0.63 per 15mg dose ?A medicare site somewhere else says... I'm a bit confused - does that mean I'm losing money every time I give it-- at least to patients with these insurances?

For those out of my region -- how much have you been getting reimbursed forthe J1885?thanks Locke, MD