What Does an Infusion Cost? Real Medicare Numbers by Drug
The price of an infusion is mostly the price of the drug. The chair, the nurse and the IV are a few hundred dollars. The drug can be a few thousand or tens of thousands of dollars a year. So the first question is always which drug you are getting.
The table below shows what Medicare paid per patient for common infusion drugs, across all of that patient's doses for the year. It is the clearest public price signal there is. Private insurance usually pays more.
Medicare Paid per Patient
Total Medicare Part B spending on each drug in 2024 divided by the number of patients who got it, from CMS Medicare Part B Spending by Drug. Includes every dose in the year; excludes the visit fee.
What You Pay With Medicare
Original Medicare Part B covers most clinic infusions at 80% after the yearly deductible. You owe the other 20% unless you have a Medigap plan or other secondary coverage. On a drug that costs Medicare $39,000 a year, 20% is close to $8,000, which is why a supplement or a drug maker's assistance program matters.
Medicare Advantage plans set their own coinsurance for Part B drugs and usually cap your yearly out-of-pocket costs. Check your plan's evidence of coverage under "Part B drugs".
Why the Same Drug Costs More at a Hospital
Hospital outpatient departments can bill a facility fee on top of the drug and the nursing time. An independent infusion clinic or a doctor's office infusion suite usually cannot. Many insurers now steer patients to lower-cost sites for that reason, so ask yours which clinics it prefers.
Five Ways to Lower Your Bill
- Ask your insurer for in-network infusion clinics, not just hospitals.
- Ask whether a biosimilar is an option, such as an infliximab biosimilar instead of Remicade.
- Check the drug maker's copay or patient assistance program.
- Get the prior authorization approval in writing before your first dose.
- If you are uninsured, ask the clinic for its cash price, especially for iron.