96450 Chemotherapy administration Medicare reimbursement rates in Pennsylvania

This service covers delivery of chemotherapy into the central nervous system, most commonly by an intrathecal route through a lumbar puncture. It may be performed in an oncology or hematology clinic, hospital outpatient department, or other setting where CNS-directed treatment is administered. Patients may receive it for conditions such as CNS leukemia or leptomeningeal disease. Administration through an intraventricular access device is also a CNS route.

Select this code based on the route of drug delivery, not the drug name or the diagnosis alone. Documentation should identify the medication, CNS route, access method, and completed administration. The spinal puncture used to access the treatment site is included in this service. The chemotherapy drug itself is separate from the administration service when separately reportable. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. Modifier 50 is inappropriate. Assistant-at-surgery payment requires medical-necessity documentation; co-surgeons and team surgery are not permitted.