CPT 96417: Continued Intravenous Chemotherapy Administration
Medicare pays $69 and commercial payers pay $165 on average nationally for this procedure.
CPT code 96417 is an add-on chemotherapy administration code used when a provider continues intravenous infusion to administer a different chemotherapy drug following a primary infusion; service type is intravenous chemotherapy infusion (continuation/add-on) and the typical site of service is an outpatient infusion center or hospital outpatient department where multi-drug IV chemotherapy is delivered.
For related coverage guidance, see recent payer policy updates: Epithelial Cell Cytology in Breast Cancer Risk Assessment, Antibody-Drug Conjugates, Chemotherapy Observation or Inpatient Hospitalization (for New Mexico Only).
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National Reimbursement Benchmarks
National averages show a clear gap between Medicare and commercial BUCA rates for CPT 96417: Medicare’s mean is $69.3 versus BUCA’s mean of $165.2, indicating BUCA averages about $95.9 higher per service than Medicare. That spread highlights material payment differences between a federal payer and an aggregated commercial benchmark, with Medicare centered near its median of $68 while BUCA sits closer to its $145 median.
Dispersion across payers varies: compute P75–P25 ranges and compare relative tightness. Blue Cross Blue Shield’s range is $95 (from $151 to $246), Aetna’s is $67 (from $66.3 to $133.2), Cigna’s is $69 (from $71 to $140), UnitedHealth Group’s is $57.5 (from $69.7 to $127.5), and BUCA’s is $82 (from $115.9 to $198.1). UnitedHealth Group is the tightest band at $57.5 and Blue Cross Blue Shield the widest at $95, with BUCA and Aetna/Cigna in between.