Oncology Billing Services
Chemo administration errors, buy-and-bill drug losses, and infusion sequencing denials cost oncology practices hundreds of thousands a year. We recover every dollar.
25+
Years in medical billing
30+
Specialties served
All 50
States supported
Dedicated
Specialty team
The Oncology Billing Challenge
Every specialty has coding landmines. Here are the ones costing oncology practices the most.
Chemo Administration Coding
$60-120K/yr96413-96417
Chemotherapy administration codes follow strict sequencing and timing rules for initial infusions, additional hours, and additional substances. Miscoding the primary vs sequential agent or missing additional-hour add-ons causes the largest revenue leak in oncology.
Buy-and-Bill Drug Management
$80-200K/yrJ9XXX codes
Oncology practices purchase drugs and bill payers at ASP-based rates. Unit conversion errors, incorrect J-code selection, missed waste billing (-JW modifier), and NDC mismatches create massive revenue leakage on the most expensive claims in the practice.
Infusion Sequencing Rules
$30-60K sequencing denials96365-96368 / 96413-96417
When chemotherapy and non-chemo infusions occur in the same session, the sequencing rules determine which is primary. Incorrect sequencing causes denials on every multi-drug session — and most practices get this wrong.
Treatment Plan Authorization
Highest-dollar auth riskAll regimens
Oncology has the highest-dollar prior authorization stakes of any specialty. A single missed or expired auth can result in a five- or six-figure denied claim for a chemotherapy session that has already been administered.
Chemo Injection Coding
Miscoded after reformulation96401-96402
Chemotherapy injection codes (IV push and non-IV) are frequently miscoded when drug formulations change. Using the infusion code when a push code applies, or vice versa, causes denials and underpayment.
Modifier-25 with Chemo Visits
$20-40K/yrModifier -25
E&M services on chemotherapy administration days require modifier-25 and documentation of a separately identifiable service. Many oncology practices skip the E&M code entirely, leaving significant office visit revenue uncaptured.
What We Handle
Complete oncology billing coverage — every code, every payer, every claim.
Chemotherapy
- IV chemo infusion (96413-96417)
- Chemo injection (96401-96402)
- Chemo IV push (96409)
- Non-chemo infusion (96365-96368)
- Hydration (96360-96361)
- Drug waste billing (-JW modifier)
Drug Management
- Buy-and-bill reconciliation
- J-code & NDC crosswalks
- ASP pricing verification
- Drug unit conversion
- Biologic & biosimilar coding
- Oral oncolytic tracking
Clinical Services
- Office E&M visits
- Hospital consultations
- Radiation therapy coordination
- Bone marrow biopsy
- Port placement & removal
- Chronic care coordination
Administrative
- Treatment plan authorization
- Regimen change re-authorization
- Eligibility verification
- Credentialing
- Appeals & reconsiderations
- Patient billing & statements
How It Works
Week 1
Free Analysis
We audit your oncology billing, identify the biggest revenue leaks, and show you the numbers.
Week 1-2
Your Team Gets to Work
Coders and billers trained in oncology connect to your system and start processing claims.
Day 30-90
Results Compound
Denial rates drop, clean claims climb, and revenue increases. You see it all in real-time dashboards.
“I highly recommend Everest A/R Management to anyone looking for a Revenue Cycle Management solution. Their team was able to dive into the mess that a previous billing company had left us in and they methodically worked through the problems and even captured what we had considered to be lost revenue. They work tirelessly through denials and appeals to make sure that we get paid for the work we’ve done. Our A/R is now accurate, and our cash flow has improved significantly. We no longer stress about our billing, and we can trust them to the point where we can focus on improving other areas of the business. Their communication is excellent, and they’ve integrated so well with our team that it feels like they are a department within our organization. We couldn’t have done it without them. Thank you to everyone on the Everest team!”
Chris Applewhite
Frequently Asked Questions
Do you have experience with chemotherapy administration coding?
How do you manage buy-and-bill drug billing?
How do you handle treatment plan authorization?
Can you handle oral oncolytic billing?
Do you integrate with our EHR?
How quickly can we get started?
Find out how much revenue your oncology practice is missing.
Free analysis from a billing expert who knows your specialty. No obligation. No contracts. Just numbers.