Kentucky · G0498

Chemotherapy Administration, Intravenous Infusion Technique; Initiation Of Infusion In The Office/clinic Setting Using Office/clinic Pump/supplies, With Continuation Of The Infusion In The Community Setting (e.g., Home, Domiciliary, Rest Home Or Assisted L in Kentucky

Kentucky Medicare Avg
$124.54
16% below national avg
National Medicare Avg
$148.58
All states combined
Billed Charge (KY)
$390.33
What providers submit
Est. Commercial (KY)
$327.84
National avg: $419.65
Est. Cash / Self-Pay (KY)
$224.43
Typical self-pay discount

Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.

136
Services in KY
7
Providers
N/A
Min Payment
N/A
Max Payment

Kentucky Pricing in Context

In Kentucky, CPT code G0498 (Chemotherapy Administration, Intravenous Infusion Technique; Initiation Of Infusion In The Office/clinic Setting Using Office/clinic Pump/supplies, With Continuation Of The Infusion In The Community Setting (e.g., Home, Domiciliary, Rest Home Or Assisted L) carries an average Medicare payment of $124.54 — 16% below the national benchmark of $148.58. 7 providers across the state submitted claims for this procedure in 2023, performing 136 total services. Individual payments in KY ranged from N/A at the low end to N/A at the high end, reflecting differences in provider setting (office vs. facility), modifiers, and the specific geographic locality code applied within the state.

The average billed charge in Kentucky is $390.33, which is the figure uninsured patients would most likely encounter before any negotiation or charity discount. Medicare, by statute, only reimburses the allowed amount — the balance between billed and paid is written off under provider participation agreements. Insured patients generally pay a negotiated rate that falls between these two figures; the exact amount depends on plan design, deductible status, and in-network participation. Because Kentucky sits below the national Medicare average, commercial rates in the state may also run lower than the US median.

Using RAND 2024 commercial-to-Medicare ratios for Temporary Procedures procedures, the estimated commercial insurance price in Kentucky lands near $327.84, with self-pay cash prices typically around $224.43. Before scheduling, patients can request a Good Faith Estimate under the No Surprises Act, compare cash rates from hospital Machine-Readable Files, and confirm whether the provider is in-network with their specific plan. This page presents CMS reference data for informational use; it does not constitute medical or financial advice.

Frequently Asked Questions

How much does Chemotherapy Administration, Intravenous Infusion Technique; Initiation Of Infusion In The Office/clinic Setting Using Office/clinic Pump/supplies, With Continuation Of The Infusion In The Community Setting (e.g., Home, Domiciliary, Rest Home Or Assisted L cost in Kentucky?

The average Medicare payment for Chemotherapy Administration, Intravenous Infusion Technique; Initiation Of Infusion In The Office/clinic Setting Using Office/clinic Pump/supplies, With Continuation Of The Infusion In The Community Setting (e.g., Home, Domiciliary, Rest Home Or Assisted L in Kentucky is $124.54, which is 16% below the national average of $148.58. Providers in KY typically bill $390.33 for this procedure.

What does Chemotherapy Administration, Intravenous Infusion Technique; Initiation Of Infusion In The Office/clinic Setting Using Office/clinic Pump/supplies, With Continuation Of The Infusion In The Community Setting (e.g., Home, Domiciliary, Rest Home Or Assisted L cost with insurance in Kentucky?

With commercial insurance in Kentucky, Chemotherapy Administration, Intravenous Infusion Technique; Initiation Of Infusion In The Office/clinic Setting Using Office/clinic Pump/supplies, With Continuation Of The Infusion In The Community Setting (e.g., Home, Domiciliary, Rest Home Or Assisted L costs an estimated $327.84. Without insurance, the estimated cash price is $224.43. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform Chemotherapy Administration, Intravenous Infusion Technique; Initiation Of Infusion In The Office/clinic Setting Using Office/clinic Pump/supplies, With Continuation Of The Infusion In The Community Setting (e.g., Home, Domiciliary, Rest Home Or Assisted L in Kentucky?

7 providers in Kentucky billed Medicare for Chemotherapy Administration, Intravenous Infusion Technique; Initiation Of Infusion In The Office/clinic Setting Using Office/clinic Pump/supplies, With Continuation Of The Infusion In The Community Setting (e.g., Home, Domiciliary, Rest Home Or Assisted L in 2023, performing 136 total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is Chemotherapy Administration, Intravenous Infusion Technique; Initiation Of Infusion In The Office/clinic Setting Using Office/clinic Pump/supplies, With Continuation Of The Infusion In The Community Setting (e.g., Home, Domiciliary, Rest Home Or Assisted L cheaper in Kentucky than the national average?

Yes — Chemotherapy Administration, Intravenous Infusion Technique; Initiation Of Infusion In The Office/clinic Setting Using Office/clinic Pump/supplies, With Continuation Of The Infusion In The Community Setting (e.g., Home, Domiciliary, Rest Home Or Assisted L costs 16% below the national average in Kentucky. The state average Medicare payment is $124.54 compared to $148.58 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.

Related

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure Editorial