MedicaidBilling CodesHigh impact
Radiation Therapy and Chemotherapy On the Same Service Date
Illinois Medicaid - HFS·IL · Oncology, Radiation Oncology·Provider Notice
Effective date
Apr 1, 2007
We identified it
Jun 21, 2026
Summary
Illinois hospitals must now bill outpatient chemotherapy and radiation therapy services on separate claims when provided on the same day. Radiation therapy continues to be billed on institutional claims at APL rates, while chemotherapy must be billed separately on professional claims under the hospital's fee-for-service provider number.
Action Required
Immediately: Billing teams at Illinois hospitals must separate chemotherapy and radiation therapy charges when both services are provided on the same outpatient visit. Bill radiation therapy on institutional claim format at APL rates and bill chemotherapy separately on professional claim format using the hospital's fee-for-service provider number. For services already billed together since April 1, 2007, submit late ancillary claims on paper UB-92 format to remove chemotherapy charges, then rebill chemotherapy separately on professional claims.