Pharmacy Question for the Week of February 19, 2018

Question:

When a patient comes in for a cancer chemo injection, can we be paid for the visit too?

Answer:

Medicare contractors will pay separately for cancer chemotherapy injections (CPT® codes 96400–96549) in addition to the visit furnished on the same day. In either case, the drug is separately payable. All injection claims must include the specific name of the drug and dosage. Identification of the drug enables you to pay for the services, according to the Medicare Claims Processing Manual, chapter 17, section 20.5.7.


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Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

CPT is a registered trademark of the American Medical Association.

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