Background: Spurred by the pandemic, chemotherapy treatments provided by alternate site infusion providers have been increasing. This diversification has the potential to increase access to care and improve patient satisfaction. However, it is currently unknown how equitably distributed these non-traditional infusion settings are, and whether these newer entrants are entering markets with need or markets with ample supply. In addition, many community oncologists are concerned about the ability to retain control over a patient’s treatment and preserve the profits earned from drug infusions. Further, there are concerns regarding the lack of robust data on the safety of alternate site chemotherapy infusions. Industry analysts anticipate steady expansion in US markets for alternate site infusion with chemotherapy being a strong driver of growth. The objective of this study was to examine the distribution of alternate site infusion services across the US. Methods: Leveraging the Medicare home health infusion (MHHI) provider database from CMS, we calculated the rate of MHHI providers per 1000 Medicare beneficiaries in each US state. We reviewed company information to determine the geographic footprint of 3 alternate site infusion providers. Results: The median MHHI rate was 0.013 per 1000 beneficiaries (CO), the average rate was 0.031, with a minimum of 0 (ND, SD, WY) and a maximum of 0.202 (IL). ND, SD, WY, IN, KY, and OK have the lowest concentration of MHHI providers, whereas OR, KS, WA, NE, CA, and IL have the highest concentration. 3 alternate site infusion providers are Option Care, UnitedHealth’s Optum Infusion Pharmacy, and Coram, CVS Specialty Infusion Services. Option Care has 162 in-person infusion centers located in 45 states. Option Care’s presence is highest in CA (24), FL (9), WA (9), OH (8), VA (8), and TX (7). UnitedHealth’s Optum Infusion Pharmacy has 30 in-person infusion suites located in 20 states, primarily concentrated in FL (6) and CA (4), but also provides home infusions in all 50 states. Like MHHI providers, neither of these alternate-site providers have locations in ND, SD, or WY. Coram announced a pilot with Cancer Treatment Centers of America in 2021 to provide home chemotherapy to patients in GA, but it is unclear if that pilot is ongoing; Coram provides home infusion therapy in 49 states. Conclusions: MHHI and alternate site infusion providers are in markets across the US. If alternate site chemotherapy infusion continues to grow, health system-owned and 3rd party entrant alternate site infusion providers are likely to prosper. Conversely, physician-owned practices could face competition and loss of important drug infusion revenue leading to increased consolidation among independent oncology providers. More research is needed to determine the impact on cost and patient outcomes of alternate site chemotherapy infusions – insights that will impact reimbursement and the rate at which these services continue to grow.