Direct RN labor cost (73 min × $0.79/min)b cost × 5 infusions
IVIg infusion supplies × 5 infusionsc
a IVIg hospital cost $70.22 shown above is based on hospital contracted prices paid to manufacturers. Starting in Q1-2011 Medicare OPPS (outpatient prospective payment system) IVIg reimbursement is $73.30/gram based on average of five IVIg brands. Medicare payment rates for Q1-2011 are based on 106% of third quarter 2010 manufacturer's reported average sales price, which serves as a proxy for hospital acquisition cost, distributor mark-up and direct overhead including storage, preparation and disposal costs).
b Center for Medicare and Medicaid Services (CMS). CY 2010 Labor file. RUC source for CPT 96365 and 96366. Assumes an average two-hour infusion (one unit each of CPT 96365 + CPT 96366), which utilizes 59 minutes and 14 minutes (total 73 minutes) of nurse clinical labor time. This value understates typical labor costs for a PE nurse operator, which is better approximated by the RUC value of $0.79/minute applied for therapeutic intravenous infusions; we used that higher labor rate in our cost model.
c CMS. CY 2010 Supplies file. RUC source for CPT 96365 and 96366.