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US · guidance

CMS Pub. 100-04, ch. 17, § 20.5.7

Injection Services

activein force · 2026-08-25 – presentas-observed

Where the sole purpose of an office visit was for the patient to receive an injection, payment may be

made only for the injection service (if it is covered). Conversely, injection services (codes 90782,

90783, 90784, 90788, and 90799) included in the Medicare Physician Fee Schedule (MPFS) are not

paid for separately, if the physician is paid for any other physician fee schedule service furnished at the

same time. Pay separately for those injection services only if no other physician fee schedule service is

being paid. However, pay separately for cancer chemotherapy injections (CPT codes 96400-96549) in

addition to the visit furnished on the same day. In either case, the drug is separately payable. All

injection claims must include the specific name of the drug and dosage. Identification of the drug

enables you to pay for the services.

History

(Rev. 397, Issued: 12-16-04, Effective: 01-01-05, Implementation: 01-03-05)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
a47670ff242155b1ef7ebfa74872e0b51cf2f473d1afa1d34575652cb9def467
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