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01/06/2026

Billing of Infusion, Injection, and Hydration Services

Scope and Coding Principles

 

  • This guideline outlines the documentation and billing requirements for therapeutic, prophylactic, diagnostic injections and infusions, and hydration services.
  • Infusions and hydrations are considered time-based services and require documented start and stop times.
  • Only one initial service code should be reported per encounter, based on the primary or key reason for the visit unless multiple IV sites are used.
  • The order in which services are delivered does not determine which service is considered the initial code.
  • Claims submissions should follow CPT coding hierarchy guidelines.
  • The following CPT hierarchy should be applied:
  1. Chemotherapy Infusions
  2. Chemotherapy Injections
  3. Therapeutic, Prophylactic, Diagnostic Infusions
  4. Therapeutic, Prophylactic, Diagnostic Injections
  5. Hydration Infusions

 

 

 CPT Code Guidance

 

Code

Description

Time / Notes

96360

Hydration; initial

31–60 mins (Do NOT report if ≤30 mins)

96361

Hydration; each additional hour

Beginning at 91 mins

96365

Therapy/prophylaxis/diagnostic infusion; initial

16–60 mins (≤15 mins = IVP)

96366

Each additional hour – same drug

Beginning at 91 mins

96367

Sequential infusion – different drug

Up to 1 hour; additional hours use 96366

96368

Concurrent infusion

16–90 mins; billed once only per encounter

96372

Subcutaneous or IM injection

Multiple injections allowed

96374

IV Push; initial drug

≤15 mins

96375

IV Push; new drug

≤15 mins; list separately

96376

IV Push; same drug (facility only)

Must be ≥30 mins from prior push

 

 

Coding Clarifications

 

  • Concurrent infusion code 96368 should be billed once per encounter only.
  • Sequential infusion services should be supported with clinical justification.
  • Sequential infusions of the same infusate mix are billed once per mix.
  • Continuous infusion across midnight is considered one encounter unless restarted or performed through separate IV access sites.
  • CPT 96376 should not be reported if the repeated IV Push administration of the same drug occurs within 30 minutes from the previous administration.

 

 

Hydration Billing Rules

 

  • Hydration services should only be billed when medically necessary.
  • Hydration services require documented start and stop times.
  • Hydration services less than 31 minutes are not billable.
  • Hydration services are not separately reimbursable when fluids are used for drug dilution, IV line patency (KVO), or concurrent administration with therapeutic or chemotherapy agents.

 

 

Documentation & Compliance Requirements

 

  • Providers should maintain complete supporting documentation including infusion sheets, nursing notes, medication administration records, and physician orders where applicable.
  • Multiple initial administration services billed during the same encounter without appropriate documentation or medical justification may not be separately reimbursable.
  • Payer and regulator-specific billing rules shall apply where applicable.
  • All records and supporting documents shall be provided to Nextcare upon request. If unavailable, services may be considered as not rendered.
  • Healthcare providers shall ensure that all claims submissions adhere to these requirements to ensure timely and accurate processing.