CMS restructures chemotherapy demonstration G codes

Why This Topic Matters

The changes affect whether certain oncology office visits qualify for the demonstration and how participating practices report encounter-level quality information. Understanding the scope of the program helps billing and coding teams follow CMS requirements and monitor upcoming guidance.

Article Sections

1. Demonstration overview and participation requirements

   Introduces the Medicare chemotherapy demonstration project and describes the practice and service setting involved. It also outlines the general participation criteria referenced by CMS.

2. Changes to the G-code structure

   Summarizes the transition away from the prior tracking approach and the introduction of a new multi-part reporting framework. The section also notes that CMS planned to provide additional details through its website and a fact sheet.

3. Qualifying cancer diagnoses

   Lists the broad cancer types that must be present as a primary diagnosis for the demonstration to apply. It also indicates that other principal diagnoses are not included.