E/M Weekly Tip: Injections and Infusions

Published 08/03/2020

Chemotherapy Administration (or Nonchemotherapy Injection and Infusion) and Evaluation and Management Services Furnished on the Same Day
For services furnished on or after January 1, 2004, Palmetto GBA will not pay for CPT code 99211, with or without CPT modifier 25, if it is billed with a nonchemotherapy drug infusion code or a chemotherapy administration code.
This also applies when it is billed with a diagnostic or therapeutic injection code on or after January 1, 2005.

For more information, please visit the Medicare Claims Processing Manual, 100-04, chapter 12, Section 30.5 F at CMS website (PDF, 1.1 MB).

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