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CMS October 2026Physician Fee Schedule · Free lookup

CPT 96401 Medicare Fee Schedule 2026

Medicare's 2026 national payment for CPT 96401 is $71.81 in a non-facility setting ($71.81 in a facility), up 8.3% from $66.31 in 2025.

National rate, October 2026
Non-facility
$71.81
Facility
$71.81
vs. 2025
+8.3%
Commercial national avg.
$104.38

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96401
20262025

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Up to 5 codes · 4 remaining

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Physician Fee Schedule·96401·National·2026, 2025
Current non-facility rate
$71.81▲0.0%
Facility: $71.81
Recent trend
Code description

Chemothera Administr Subcutane Or Intramuscul; Non-Hormon, Chemotherapy Administration Subcutaneous Or Intramuscular; Non-Hormon

CodeDateStateLocalityCarrierNon-Facility FeeFacility FeeDescription
9640110/2026N/A0000000$71.81$71.81Chemothera Administr Subcutane Or Intramuscul; Non-Hormon, Chemotherapy Administration Subcutaneous Or Intramuscular; Non-Hormon
964017/2026N/A0000000$71.81$71.81Chemothera Administr Subcutane Or Intramuscul; Non-Hormon, Chemotherapy Administration Subcutaneous Or Intramuscular; Non-Hormon
964014/2026N/A0000000$71.81$71.81Chemothera Administr Subcutane Or Intramuscul; Non-Hormon, Chemotherapy Administration Subcutaneous Or Intramuscular; Non-Hormon
964011/2026N/A0000000$71.81$71.81Chemothera Administr Subcutane Or Intramuscul; Non-Hormon, Chemotherapy Administration Subcutaneous Or Intramuscular; Non-Hormon
9640110/2025N/A0000000$66.31$66.31Chemothera Administr Subcutane Or Intramuscul; Non-Hormon, Chemotherapy Administration Subcutaneous Or Intramuscular; Non-Hormon
964017/2025N/A0000000$66.31$66.31Chemothera Administr Subcutane Or Intramuscul; Non-Hormon, Chemotherapy Administration Subcutaneous Or Intramuscular; Non-Hormon
964014/2025N/A0000000$66.31$66.31Chemothera Administr Subcutane Or Intramuscul; Non-Hormon, Chemotherapy Administration Subcutaneous Or Intramuscular; Non-Hormon
964011/2025N/A0000000$66.31$66.31Chemothera Administr Subcutane Or Intramuscul; Non-Hormon, Chemotherapy Administration Subcutaneous Or Intramuscular; Non-Hormon

96401 national rate by year

Each row is the latest CMS file published that year. Change is against the year before.

CMS fileNon-facilityFacilityChange
October 2026$71.81$71.81+8.3%
October 2025$66.31$66.31-7.3%
March 2024$71.57$71.57-2.7%
January 2023$73.54$73.54-5.6%
July 2022$77.86$77.86-

This is the national amount before geographic adjustment. Medicare multiplies each relative value unit by its locality's geographic practice cost index, so a practice's own allowed amount can be higher or lower; pick a state above to see its localities. The facility amount applies when the service is performed in a hospital or other facility setting.

96401: Medicare vs. commercial national average

The commercial national average for 96401, the mean of what BCBS, UnitedHealthcare, Aetna and Cigna publish nationwide, is $104.38, 145% of Medicare's $71.81.

  • BCBS $102.12
  • UnitedHealthcare $91.91
  • Aetna $100.39
  • Cigna $123.09

A national average, not a local rate: each payer's figure averages the unmodified, in-network professional rates it publishes for 96401 across the country in its transparency files. Contracted rates vary widely by market, provider and plan. Medicare's figure is its national non-facility amount before geographic adjustment.

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Medicaid comparison

See what state Medicaid programs pay for 96401

50 state Medicaid agencies publish their own physician fee schedule. The 96401 page shows real published rates for several of them free, with effective dates and official sources.

17,674 codes and 974,327 published rates, taken from the files the state agencies publish themselves.