$117.06
96413 reports the primary intravenous chemotherapy infusion. Use 96417 for an additional different drug infused sequentially after that primary service.
On this page
CMS RVU26D · Effective 2026-10-01
96417 Chemotherapy infusion Medicare reimbursement rates in Alabama
Reports an additional sequential intravenous infusion of a different chemotherapy drug or substance, following a primary chemotherapy infusion service. Compare 96417 office and facility rates across CMS payment localities in Alabama.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 96417 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$58.73
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Chemotherapy administration
About 96417: Sequential intravenous chemotherapy infusion
Reports an additional sequential intravenous infusion of a different chemotherapy drug or substance, following a primary chemotherapy infusion service.
This code represents an additional sequential intravenous infusion of a different chemotherapy drug or substance, generally administered by clinical staff in an oncology office or infusion setting. The next drug is given in sequence rather than concurrently with the preceding infusion. It is distinct from extra time spent continuing the same drug and from chemotherapy delivered by injection or prolonged pump infusion.
Report it as an add-on with the primary chemotherapy administration service when documentation supports a separate sequential infusion of another drug. The medication administration record and infusion documentation should identify the drugs and show their sequence and administration times. For Medicare, this add-on is paid within the primary procedure's global period. CMS classifies it as an incident-to service, so it is billed only when performed under physician supervision.
CMS billing rules for 96417
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
- Professional and technical components
- Incident-to service: billed only when performed under physician supervision.
Where the value comes from
- Work RVU0.21 · 11%
- Practice expense (office) RVU1.75 · 88%
- Malpractice RVU0.03 · 2%
323.3K
Medicare services in 2024 · #295 by national volume
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
96417 compared with similar codes
Office rates for Alabama, from the same CMS release.
$25.43
96415 reports additional time when an infusion continues; 96417 represents a separate sequential infusion of a different drug or substance.
$50.50
96411 is for an additional chemotherapy drug administered by intravenous push. 96417 is for a different drug given as a sequential infusion.
$116.77
96416 describes prolonged chemotherapy infusion using a pump. 96417 identifies an additional sequential infusion of a different drug.
Compare 96417 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
$58.73
Facility
Unavailable
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 96417 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
12,804
- Code
- 96417
- Physician work
- 0.21
- Practice expense
- 1.75
- Malpractice
- 0.03
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.21 | × 1.000 | 0.2100 |
| Practice expense | 1.75 | × 0.875 | 1.5313 |
| Malpractice | 0.03 | × 0.566 | 0.0170 |
| Total RVUs | 1.7582 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Alabama$58.73
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.21 | 1 |
| Practice expense | 1.75 | 0.875 |
| Malpractice | 0.03 | 0.566 |
(0.21 × 1 + 1.75 × 0.875 + 0.03 × 0.566) × $33.4009 = $58.73
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
96417 billing questions
When is 96417 reported with 96413?
Report 96417 for an additional sequential infusion of a different chemotherapy drug after the primary infusion service. It is an add-on and cannot stand alone.
Is 96417 for extra time with the same drug?
No. It represents a sequential infusion of a different drug or substance; 96415 is used for additional infusion time when the same infusion continues.
Can 96417 describe a concurrent infusion?
No. The additional drug must be infused sequentially, not concurrently with the preceding infusion.
What documentation supports a unit of 96417?
Document the additional drug, its sequential administration, and the infusion times in the medication administration and infusion records. The service represents an additional sequential infusion, not another hour of the same infusion.
What supervision is required for Medicare billing?
CMS classifies 96417 as an incident-to service. It is billed only when performed under physician supervision.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
12,80196413,,Chemo iv infusion 1 hr,A,,0.28,3.64,,3.64,NA,0.07,3.99,3.99,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,80296415,,Chemo iv infusion addl hr,A,,0.19,0.64,,0.64,NA,0.02,0.85,0.85,5,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,80396416,,Chemo prolong infuse w/pump,A,,0.21,3.71,,3.71,NA,0.07,3.99,3.99,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,80496417,,Chemo iv infus each addl seq,A,,0.21,1.75,,1.75,NA,0.03,1.99,1.99,5,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,80596420,,Chemo ia push tecnique,A,,0.17,2.92,,2.92,NA,0.06,3.15,3.15,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,80696422,,Chemo ia infusion up to 1 hr,A,,0.17,3.96,,3.96,NA,0.07,4.20,4.20,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,80796423,,Chemo ia infuse each addl hr,A,,0.17,2.04,,2.04,NA,0.05,2.26,2.26,5,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515