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Part A Outpatient Infusion and Hydration Services
Last Modified: 6/4/2025
Location: FL, PR, USVI
Business: Part A
Outpatient hydration therapy refers to the intravenous (IV) administration of fluids (typically pre-packaged with saline fluid and/or electrolytes) without the addition of drugs or other therapeutic agents.
• It is intended to correct or prevent dehydration or restore fluid balance.
• It is not used for the delivery of medications, flush IV lines, deliver or administer a drug/substance.
• It must be reasonable and necessary and clearly documented as such.
• CPT 96360 intravenous infusion hydration initial, 31 minutes to 1 hour.
• CPT +96361 report for each additional hour of hydration infusion intervals of greater than 30 minutes beyond 1-hour increments.
Note: + sign indicates add-on code (AOC)
There are times it is reasonable and necessary to include hydration in conjunction or before/after the administration of certain drugs/substance, this must be clearly documented as a separate service and support medical necessity.
Outpatient infusion therapy refers to the intravenous (IV) administration of a drug or substance directly into the blood stream.
• Billed based upon the CPT/HCPCS description of the service rendered.
• May bill for the total time of the infusion using add-on codes if the start and stop times are documented.
• To bill an IV infusion, a delivery of more than 15 minutes is required for safe and effective administration.
There are administration categories related to IV hydration and infusions.
• Initial: There is only one “initial” service per patient encounter, no matter how many drugs are administered.
• The only exception is if two separate IV sites are necessary, or the patient returns for a separate and reasonable and necessary encounter on the same day.
Initial Service CPT |
Short Description |
96360 |
IV hydration |
96365 |
IV for therapy |
96369 |
Subcutaneous infusion for therapy |
96374 |
Intravenous push single or initial substance/drug |
96409 |
Intravenous push technique, single or initial drug/substance |
96413 |
Chemotherapy administration, intravenous infusion technique; up to one hour, single or initial substance or drug |
• Sequential: Sequential infusion refers to the IV administration of a second or subsequent therapeutic, prophylactic, or diagnostic drug or substance that is an infusion or IV push of a new substance or drug following a primary or initial service.
• Concurrent: Concurrent infusion is the IV administration of multiple therapeutic, prophylactic, or diagnostic substances or drugs of a new substance through the same IV line at the same time as another substance or drug.
Add-on codes must be billed with the primary initial code.
Add-on Code CPT |
Short Description |
+96366 |
Each additional hour of IV infusion (after initial 1 hour) |
+96367 |
Additional sequential infusion of a different drug/substance |
+96368 |
Concurrent infusion of a different substance or drug |
+96361 |
Each additional hour of hydration |
+96415 |
Each additional hour of chemotherapy infusion |
+96417 |
Additional sequential infusion of different chemo drug |
Hierarchy rules apply to Part A outpatient hydration and infusion services
There are hierarchy rules associated with facility reporting of the initial service. If a patient receives two or more services, the highest-ranking service provided is considered the initial service.
The list below is the hierarchy for facility reporting. The highest rank is chemotherapy infusions the lowest rank is hydration services.
• Chemotherapy infusions
• Chemotherapy IV pushes
• Chemotherapy injections
• Therapeutic/Prophylactic/Diagnostic infusions
• Therapeutic/Prophylactic/Diagnostic IV pushes
• Therapeutic/Prophylactic/Diagnostic injections
• Hydration
NOTE: Intermuscular injections (IM) are not included in the hierarchy
Hydration and infusion codes are time-based; therefore, proper documentation of start and stop times will help determine coding hierarchy. Document start and stop times for hydration and/or each drug/substance administered as well as patient name, medication/treatment record with date, drug, dosage, time, method of administration, and signature of administrator.
Resources:
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