Remicade - insurance coverage?

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Joined
Jun 23, 2015
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Hi,
I am in the midst of determining whether my insurance (Blue Cross Blue Shield) will cover the Remicade injection.

The provider said they provide the injection in a hospital outpatient facility.

But BCBS says they only cover this procedure code (J1745 which is specific to remicade i think based on google) for remicade in a doctor's office, patients' home or a nursing home.

Where do you receiving your injection?

I am wondering whether I will be able to find a doctors office to receive it. Or if my doctor can prescribe it via home health care.
 
Remicade is an infusion. Some GIs use the IV or infusion clinics at hospitals, others have infusion clinics at their office or use stand alone infusion clinics. There is also the possibility of having home infusions in some areas with some insurance carriers.

When my son was on Remicade we recieved them at his GIs office because his GI group had an in office infusion clinic.

My son is now on Humira instead of remicade. Humira is a biologic also but it is a self injection. So a humira nurse came out and showed him how to perform the injections and he self injects every 14 days.
 
Ds had remicade at a hospital infusion clinic.
Due to the risk of anaphylaxis it was required to be given there
 
Infusion clinic at a hospital here too, with full coverage. It is billed as chemotherapy also, with no co-pay.
 
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