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See a sample rate comparisonCPT 96417 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Chemo Iv Infus Each Addl Seq, Chemotherapy Administration Intravenous Infusion Technique; Each Additional Sequential Infusion (Different Substance/ Drug) Up To 1 Hour (List Separately In Addition To Code For Primary Procedure)
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Hydration, Therapeutic, Prophylactic, Diagnostic Injections and Infusions, and Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $66.47 national non-facility rate (2026) · View Medicare rates for 96417 |
| Medicaid Fee Schedule | $53.435 median of the 8 states in the free preview · View Medicaid rates for 96417 |
National average reimbursement for CPT 96417 by major payers:
$100.44
$88.36
$94.05
$115.02
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CPT 96417
5 of 25 sample ratesHigher to lower in this preview
Sean Naini
$145.67Published rateJose Sanchez-Pena
North Logistic Services Inc
$98.44Published rateMedical Group Associates, LLC
$80.91Published rateSatvinder Dhillon
Mercer Regional Medical Associates
$66.37Published rateCarl Restivo
Carl Restivo Jr Md PA
$50.31Published rate
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See a sample payer proposalCPT 96417 vs. Other Hydration, Therapeutic, Prophylactic, Diagnostic Injections and Infusions, and Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration Codes
The CPT 96417 code is part of the Medicine Services and Procedures services used for Hydration, Therapeutic, Prophylactic, Diagnostic Injections and Infusions, and Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 96417 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 96413-CPT | Low | Infusion Of Chemotherapy, Infusion Of A Chemotherapy Agent Or Other Complex Drug Into A Vein. An Infusion Delivers A Fluid And/Or Medication Slowly Over A Period Of Time. |
| 96415-CPT | Low | Infusion Of Chemotherapy, Infusion Of A Chemotherapy Agent Or Other Complex Drug Into A Vein. An Infusion Delivers A Fluid And/Or Medication Slowly Over A Period Of Time. |
| 96416-CPT | Moderate | Chemo Prolong Infuse W Pump, Chemotherapy Administration Intravenous Infusion Technique Initiation Of Prolonged Chemotherapy Infusion More Than 8 Hours Requiring Use Of A Portable Or Implantable Pump |
| 96417-CPT | Low | Chemo Iv Infus Each Addl Seq, Chemotherapy Administration Intravenous Infusion Technique; Each Additional Sequential Infusion (Different Substance/ Drug) Up To 1 Hour (List Separately In Addition To Code For Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 96417. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 96417 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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