Overview

Chemotherapy is covered when it is provided by a participating provider in an inpatient hospital setting, at the participating physician group (PPG) or other outpatient setting, or in the member's home. Visits for treatment are not considered office visits.

Health Net's capitated home infusion provider must be used for home chemotherapy services for Health Net members. If a delegated PPG does not use the capitated home infusion provider to provide home chemotherapy, the services are the PPG's responsibility.