How to Help Your Patients Save Money on MicRhoGAM: A Provider's Guide to Savings Programs

Patients experiencing early pregnancy loss face a difficult combination of emotional distress and urgent medical need — and for some, cost concerns about MicRhoGAM can compound that stress. As a provider, being prepared to address cost questions quickly and accurately helps your patients access a medication they critically need without delay.

This guide summarizes how MicRhoGAM is billed, what your patients are likely to pay under different insurance scenarios, and resources for uninsured and underinsured patients.

How MicRhoGAM Is Typically Billed

Because MicRhoGAM is a professionally administered injectable biologic — not a self-administered medication — it is almost always billed as a medical benefit rather than a pharmacy benefit. This distinction matters significantly for what your patients pay:

Medical benefit (administered in your office, hospital, or clinic): Billed under the patient's major medical coverage. Typically involves the medical deductible and office visit copay/coinsurance — not the pharmacy deductible. For preventive obstetric care, many plans cover it with minimal or no cost sharing.

Pharmacy benefit (patient fills prescription at retail pharmacy, brings to office): Billed through the patient's prescription drug plan. Injectable biologics often fall on specialty drug tiers, with variable copays ranging from $0–$150+ depending on the plan.

Coverage by Insurance Type

Private Insurance (ACA Marketplace and Employer Plans)

Rho(D) immune globulin is covered under most private health insurance plans as a standard obstetric and preventive care service. Under ACA mandates, many preventive services are covered at no cost share — and RhIg is generally included as a preventive obstetric intervention under the Women's Preventive Services Initiative.

When administered in your office, the drug should be billed under your NPI with the appropriate J-code (J2790 for Rho(D) immune globulin, full dose; J2788 for mini-dose) plus your administration code (96372 for IM injection in most cases). Verify the correct J-code with your billing department — mini-dose vs. full-dose products have different J-codes.

Medicaid

Medicaid covers Rho(D) immune globulin as a medically necessary obstetric service in all 50 states. Medicaid patients typically pay nothing or a minimal copay for clinical obstetric services. Ensure your practice is enrolled in your state's Medicaid program and that the appropriate J-codes are being billed.

Medicare Part B

For Medicare patients who are of childbearing age, MicRhoGAM administered in an outpatient clinical setting is billable under Medicare Part B as a "drug administered incident to physician services." The standard 20% Part B coinsurance applies after the annual deductible ($257 in 2025). Supplemental (Medigap) insurance may cover the coinsurance.

Resources for Uninsured and Underinsured Patients

Uninsured patients face the greatest cost burden. MicRhoGAM's cash price at retail pharmacies ranges from approximately $100–$300+ per dose. Key resources to direct these patients:

Federally Qualified Health Centers (FQHCs): FQHCs are required to serve patients regardless of ability to pay, with fees on a sliding scale based on income. Locate them via findahealthcenter.hrsa.gov. Many FQHCs maintain RhIg stock for obstetric patients.

Hospital financial assistance programs: Hospitals that receive Medicare or Medicaid funding are required to have financial assistance policies. Patients receiving MicRhoGAM in a hospital setting can apply retroactively for charity care.

NeedyMeds.org and RxAssist.org: Comprehensive databases of patient assistance programs. Search for Rho(D) immune globulin or biologic injection programs that may assist with cost.

Planned Parenthood and reproductive health clinics: These clinics often provide RhIg on sliding-scale fees for uninsured patients who have experienced early pregnancy events.

340B Drug Pricing Program

Qualifying covered entities (including FQHCs, rural health clinics, and certain hospital outpatient departments) can purchase MicRhoGAM through the 340B drug pricing program at significantly reduced costs. If your practice is a 340B covered entity, ensure your pharmacy is enrolled to procure and dispense MicRhoGAM at 340B pricing — this reduces your acquisition cost significantly and allows more affordable administration for uninsured patients.

Manufacturer Assistance

Kedrion Biopharma does not have a widely publicized direct-to-patient assistance program for MicRhoGAM. For patients who have exhausted other options, contacting Kedrion Biopharma directly (1-855-353-7466) or their specialty distributor may surface access options. The ASHP Drug Shortage Bulletin (updated September 2025) may also include updated availability and ordering information.

Staff Scripts: Addressing Cost Questions From Patients

When patients ask about cost at the point of care, your staff can reassure them:

"Most insured patients pay very little or nothing for this injection when it is given in our office."

"If you are uninsured, we will connect you with our financial counselor to discuss options including sliding-scale fees and assistance programs."

"We can help you find this medication if your pharmacy is out of stock — please don't delay this injection because of availability concerns."

For guidance on helping patients locate MicRhoGAM at pharmacies, see our provider's guide to helping patients find MicRhoGAM in stock. You can also direct patients to medfinder for providers to locate pharmacy availability near them.