Chemotherapy is the use of chemicals or medications to kill cancer cells.
Most chemotherapy is delivered intravenously.
Code 96408 Chemotherapy administration Coverage for hospital expense: 5,600 pesos Coverage for professional fee (PF): 1,680 pesos Total coverage: 7,280 pesos Code 96440 Chemotherapy administration into pleural cavity, requiring and including thoracentesis Coverage for hospital expense: 4,300 Coverage for professional fee (PF): 1,260 Total coverage: 5,560 Code 96445 Chemotherapy administration into peritoneal cavity, requiring and including peritoneocentesis Coverage for hospital expense: 5,500 Coverage for professional fee (PF): 2,520 Total coverage: 8,020 Code 96450 Chemotherapy administration into CNS, requiring and including spinal puncture Coverage for hospital expense: 4,300 Coverage for professional fee (PF): 1,260 Total coverage: 5,560 Code 96542 Chemotherapy injection, subarachnoid or interventricular via subcutaneous reservoir Coverage for hospital expense: 2,800 Coverage for professional fee (PF): 840 Total coverage: 3,640 Code 36640 Arterial catheterization for prolonged infusion therapy (chemotherapy), cutdown Coverage for hospital expense: 2,800 Coverage for professional fee (PF): 840 Total coverage: 3,640
Rules on Chemotherapy Coverage:
Chemotherapy (RVS 96408) a. The case rate amount for chemotherapy is equivalent to one cycle of chemotherapy. b. One cycle of chemotherapy is equivalent to 2 days deduction from the 45 days benefit allowance. c. Chemotherapy may be claimed as inpatient or outpatient. i. If claimed as inpatient and in the same hospital, the chemotherapy package may be claimed as first or second case rate. ii. Multiple cycles may be claimed in one claim form for both inpatient and outpatient chemotherapy. The dates of each cycle claimed shall be indicated in the space provided in Claim Form 2.