CPT Code 96401: Chemotherapy Administration, Subcutaneous or Intramuscular

CPT code 96401 is used for the administration of non-hormonal, antineoplastic chemotherapy drugs by subcutaneous or intramuscular injection, reflecting the higher complexity, risk, and monitoring required for chemotherapy agents. In contrast, 96372 is for therapeutic, prophylactic, or diagnostic injections (such as routine medications or vaccines) delivered subcutaneously or intramuscularly, and is not intended for chemotherapy or highly complex biologic agents.

Both 96401 and 96402 are chemotherapy administration codes for subcutaneous or intramuscular injections, but the difference lies in the type of drug administered. 96401 is used for non-hormonal antineoplastic agents, while 96402 is designated for hormonal antineoplastic agents.

You may bill 96401 more than once during a visit if multiple non-hormonal, antineoplastic chemotherapy drugs are administered by separate injections, provided each injection is distinct and not overlapping in time or mixed in the same syringe. However, payer policies may vary, and some insurers may consider additional administrations incidental, so it is essential to review payer-specific guidelines.