Minimize spinal nerve injection costs and epidural steroid injection costs by being pro-active consumers.
1) INSURANCE COVERAGE:
Auto insurance and worker’s compensation are frequently the primary insurance coverage for pain management. If nerve blocks are administered to manage pain caused by a car accident injury, your health insurance provider will not cover your treatment if there is an auto insurance medical policy in place. Similarly, if your nerve block injection is part of a pain management program to treat a work-related injury, then your health insurance will likely decline coverage because your state worker’s compensation fund should cover the injury.
Providers, like physicians and surgery centers, generally love auto insurance medical coverage because they pay providers very high rates. Auto insurance companies are generally not very astute healthcare purchasers.
2) SITE OF SERVICE:
Nerve block costs to the patient can vary widely depending on where they are performed. There are three different places you can have a nerve block.
The most cost-effective place to have a nerve block administered is in the office of a pain management physician specialist. Having a nerve block administered in an ambulatory surgery center or hospital is more expensive than getting a nerve block in a physician’s office. There are three major reasons that a physician may want to perform a nerve block in a more expensive setting like an ambulatory surgery center or hospital.
|Procedure||MD@Office||MD@ASC||+ASC Fee||=Total||Coins Diff|
|Epidural Nerve Block (62310)||$247||$107||$301||$408||$32|
|Lumbar/Sacral, Steroid Injct (64483)||$242||$112||$301||$413||$24|
|Paravertebral Pain Injection (64493)||$181||$93||$301||$394||$43|
3) PHYSICIAN SPECIALISTS:
It is my opinion that patients can save money by seeing an anesthesiologist or physiatrist that is a “pain management specialist” as opposed to a surgery-focused anesthesiologist that performs pain management “on the side”. Pain management specialists are more likely to have real, office-based clinics where they can perform you nerve block instead directing you to a hospital or surgery center, which would bill you in addition to the physician’s fee.
Nerve block costs can grow significantly when they are performed over a series of visits. When this happens, a patient may return to the physician several times to receive additional injections over the course of several weeks or months.
If I had a high-deductible and was trying to keep nerve block costs down, I would avoid surgery centers like the plague and find myself a pain management physiatrist that would agree to take a fee of no more than $450 for each visit, not each procedure. Expect 2-3 “procedures” each visit. I would not pay more than $450 for a single visit if I had a high-deductible.
5) TREATMENT COST–ALMOST NOTHING:
The real cost of a nerve block is about $60 in supplies. In the grand scheme of things, nerve blocks are one of the cheapest outpatient procedures to perform next to colonoscopy. What you are really paying for is the technical expertise of the physician. If you ever find yourself with a high-deductible and a $1,000 facility fee for the first of three nerve block, you are probably in a pretty good position to barter.