Skip to main content
  • Medicaid Provider Alert: Provider revalidation has begun and those not completing the process risk disenrollment.  Check your account now to learn when your revalidation is due. More information here.
Elizabeth M. Whitehorn, Director

Provider Notice issued 04/13/06

Billing for Chemotherapy Administration

​To: ​Participating Hospitals, Physicians and Advanced Practice Nurses
​Date: ​April 13, 2006
​Re: ​Billing for Chemotherapy Administration

The purpose of this bulletin is to advise providers of changes in the department’s billing requirements for chemotherapy administration. Payment for chemotherapy administration may be made to physicians, APNs, and to hospitals billing fee-for-service. Physicians and APNs may only bill for the administration of chemotherapy in the office setting. Hospitals may bill fee-for-service for the administration in the hospital outpatient setting.

The department’s reimbursement is not based upon the temporary C-Series of HCPCS codes utilized by Medicare. Using these codes on a Medicaid claim will cause the claim to reject. However, the C-Series codes can be reported on Medicare crossover claims, as long as the appropriate CPT chemotherapy administration codes are reported. Providers submitting Medicare crossover claims with only C-Series codes will not be reimbursed for the chemotherapy administration.

The Handbook for Providers of Physician Services, Chapter A-200 has been revised to reflect the billing changes and is available on the department’s Web site at: <http://www.hfs.illinois.gov/handbooks/> . If you do not have access to the Internet, or need a paper copy, printed copies are available upon written request. You need to specify a physical street address to ensure delivery. Submit your written request or fax to:

Healthcare and Family Services
Provider Participation Unit
Post Office Box 19114
Springfield, Illinois 62794-9114
Fax Number: 217-557-8800
E-mail address is HFSwebmaster @illinois.gov

To reduce copying and mailing cost, the department may not always include hardcopies of attachments referenced in notices and bulletins. Web site links are identified so providers may view and print the material from the Internet.

If you have questions regarding this notice, please contact the Bureau of Comprehensive Health Services at 1-877-782-5565.

INSTRUCTIONS FOR UPDATING HANDBOOK

Topic A-229 – Chemotherapy for Malignant Disease

Remove page November 2001 II-A-36 and insert new page April 2006 II-A-36