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 living) using a portable pump provided by the office/clinic, includes follow up office/clinic visit at the conclusion of the infusion
Medicare coverage: Carrier judgment
Status: active (October 2026 file)
Medically Unlikely Edits (effective October 1, 2026)
Practitioner: max 1 units per day (policy), rationale: Code Descriptor / CPT Instruction
Outpatient hospital: max 1 units per day (policy), rationale: Code Descriptor / CPT Instruction
Medicare pricing for G0498
Physician Fee Schedule (CY 2026, RVU26D)
Status C: contractor-priced by the MAC.
Payer policies and prior authorization for G0498
Medicaid fee-for-service
AZ: $225.29 (outpatient_hospital), effective Oct 1, 2021
IN: $126.24 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2024
From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.