Oncology Billing Services
Oncology billing is high-dollar and high-complexity. Chemotherapy administration, drug coding (J-codes), radiation therapy, and complex E/M for treatment planning require specialty billing expertise.
Why Oncology Billing Requires Specialty Expertise
Oncology billing involves chemotherapy/infusion administration codes (96413-96417), drug product codes (J-codes), radiation therapy coding (77385-77387), and high-complexity E/M for treatment planning. Drug reimbursement (buy and bill) is a significant revenue component.
Common Oncology CPT Codes
Our coders handle these oncology codes daily. This is not an exhaustive list.
2026 Medicare Allowables for Oncology CPT Codes by State
Medicare reimbursement for oncologyprocedures is not a single national number. Each code's allowable is adjusted by your state's Geographic Practice Cost Index (GPCI) and processed under that state's Medicare Administrative Contractor (MAC), so the same oncology CPT code pays a different amount in California than it does in Texas or Florida. The table below shows the 9 core oncologycodes our coders bill priced at each state's 2026 locality. The non-facility figure is what an office-based practice collects. The facility figure applies when the service is performed in a hospital-based setting.
Commercial carriers in each state typically reimburse above these Medicare benchmarks and state Medicaid below them, but the Medicare allowable is the contracting anchor every payer negotiation starts from. Compare any individual code across all states with our Medicare fee calculator by state.
| Code | Oncology Procedure | CA | TX | FL | NY | PA | IL | OH | GA | NC | MI |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 96401 | Chemotherapy administration, subcutaneous or intramuscular | $83.08 | $70.77 | $73.29 | $79.96 | $70.66 | $70.91 | $66.30 | $69.16 | $67.08 | $68.48 |
| 96409 | Chemotherapy administration, IV push, single drug | $121.24 | $102.98 | $106.75 | $116.57 | $102.81 | $103.21 | $96.34 | $100.60 | $97.49 | $99.59 |
| 96413 | Chemotherapy administration, IV infusion up to 1 hour | $154.82 | $131.27 | $135.89 | $148.61 | $131.02 | $131.33 | $122.71 | $128.15 | $124.28 | $126.81 |
| 96365 | Therapeutic IV infusion, initial, up to 1 hour | $77.55 | $66.17 | $68.60 | $74.74 | $66.09 | $66.39 | $62.03 | $64.70 | $62.71 | $64.09 |
| 96360 | Hydration IV infusion, initial, 31 minutes to 1 hour | $38.47 | $32.98 | $33.81 | $36.96 | $32.91 | $32.80 | $31.02 | $32.22 | $31.45 | $31.87 |
| 77373 | Stereotactic body radiation therapy treatment delivery | $1,152.66 | $963.01 | $989.79 | $1,093.82 | $959.33 | $953.50 | $894.30 | $935.65 | $910.62 | $922.86 |
| 77300 | Basic radiation dosimetry calculation | $75.63 | $66.44 | $68.55 | $73.86 | $66.47 | $66.88 | $63.17 | $65.33 | $63.59 | $64.89 |
| 99214 | Established patient office visit, moderate MDM | $148.01 | $134.59 | $140.26 | $148.05 | $135.13 | $137.84 | $129.83 | $133.55 | $129.44 | $133.44 |
| 99215 | Established patient office visit, high MDM | $209.36 | $190.98 | $199.34 | $209.96 | $191.83 | $196.01 | $184.45 | $189.69 | $183.70 | $189.65 |
Full Oncology fee detail by state
2026 Medicare allowables for oncology CPT codes in California, processed under Noridian Healthcare Solutions (Jurisdiction E). See California medical billing.
| Code | Description | Non-Facility | Facility |
|---|---|---|---|
| 96401 | Chemotherapy administration, subcutaneous or intramuscular | $83.08 | $83.08 |
| 96409 | Chemotherapy administration, IV push, single drug | $121.24 | $121.24 |
| 96413 | Chemotherapy administration, IV infusion up to 1 hour | $154.82 | $154.82 |
| 96365 | Therapeutic IV infusion, initial, up to 1 hour | $77.55 | $77.55 |
| 96360 | Hydration IV infusion, initial, 31 minutes to 1 hour | $38.47 | $38.47 |
| 77373 | Stereotactic body radiation therapy treatment delivery | $1,152.66 | $1,152.66 |
| 77300 | Basic radiation dosimetry calculation | $75.63 | $75.63 |
| 99214 | Established patient office visit, moderate MDM | $148.01 | $87.54 |
| 99215 | Established patient office visit, high MDM | $209.36 | $130.32 |
Source: 2026 Medicare Physician Fee Schedule, locality-adjusted by state MAC. Figures are for reference and contracting benchmarks, not a guarantee of payment.
Oncology Billing Challenges We Solve
Common billing problems in oncology and how our team handles them.
Drug Coding (J-Codes)
Correct HCPCS drug codes with exact dosage units. NDC numbers required by many payers.
Infusion Administration
Sequential, concurrent, and add-on infusion codes based on timing and technique.
Buy and Bill
Drug acquisition cost management and adequate reimbursement negotiation.
Radiation Therapy
Treatment planning, simulation, and delivery codes with precise fraction tracking.
Common Oncology Denial Reasons
We prevent these before submission and appeal aggressively when they occur.
Revenue Opportunities Most Oncology Practices Miss
Payer-Specific Oncology Billing Tips
Oncology Billing Best Practices
Practical tips from our coding team to maximize reimbursement and minimize denials.
Get Expert Oncology Billing Support
Free billing assessment for your oncology practice. See where revenue is leaking.
What We Handle for Oncology Practices
Why Choose Go Medical Billing for Oncology
Oncology is high-dollar billing where coding errors are magnified. Our team handles drug coding, infusion administration sequencing, and radiation therapy with the precision this specialty demands.
We serve oncology practices in all 50 states, starting at 2.49% of collections. Our credentialing team handles payer enrollment, and our A/R specialists recover aging claims.
Oncology Billing by State
We handle oncology billing in all 50 states. The 2026 Medicare allowables for oncology CPT codes in every state are in the fee table above. Open any state below for its full payer environment, Medicaid rules, and Medicare MAC policies.
Frequently Asked Questions
Get Expert Oncology Billing Support
Stop losing revenue to oncology coding errors and preventable denials. Call 888-701-6090 for a free billing assessment.