Summary & Overview
CPT 96374: Intravenous Push Injection, Single or Initial Drug
CPT code 96374 represents the intravenous push administration of a single or initial therapeutic, prophylactic, or diagnostic substance or drug. This procedure is a cornerstone in acute and chronic care settings, enabling rapid delivery of medications for conditions such as chest pain, hypertension, and nausea. The code is widely recognized and reimbursed by major national payers, including Aetna, Blue Cross Blue Shield, Cigna Health, Medicare, and UnitedHealthcare.
This publication provides a comprehensive overview of 96374, detailing its clinical context, typical sites of service, and its role within medicine services and procedures. Readers will gain insight into payer coverage, relevant policy updates, and benchmarks for utilization. The analysis also highlights associated clinical diagnoses and related CPT codes, offering a clear understanding of how 96374 fits into broader care pathways. With its frequent use in both hospital outpatient and office settings, understanding the nuances of this code is essential for healthcare professionals, administrators, and policy stakeholders seeking to optimize billing practices and ensure compliance with payer requirements.
CPT Code Overview
CPT code 96374 is used to report the administration of a therapeutic, prophylactic, or diagnostic injection via intravenous push, specifically for a single or initial substance or drug. This procedure falls under Medicine Services and Procedures and is commonly performed in both facility and office settings, such as hospital outpatient departments or physician offices. The code is typically reported under place of service codes POS 11 (Office) or POS 19–22 (Outpatient Hospital). Accurate coding of this service is essential for proper billing and reimbursement across a range of clinical scenarios.
Clinical & Coding Specifications
Clinical Context
A patient presents to a hospital outpatient department or physician office with symptoms such as chest pain, nausea with vomiting, or an acute exacerbation of chronic obstructive pulmonary disease. After evaluation, the provider determines that an intravenous medication is required for therapeutic, prophylactic, or diagnostic purposes. The provider or a qualified nurse administers a single or initial intravenous push of the specified substance or drug. The procedure is documented and coded as 96374. This workflow is typical for acute presentations requiring immediate medication delivery, such as antiemetics for nausea, antihypertensives for elevated blood pressure, or bronchodilators for COPD exacerbation.
Coding Specifications
-
Modifier
25: Used when a significant, separately identifiable evaluation and management service is performed by the same physician or other qualified health care professional on the same day as the procedure or other service. This modifier distinguishes the E/M service from the injection procedure. -
Provider Taxonomies:
| Taxonomy Code | Specialty Name |
|---|---|
207RI0011X | Interventional Cardiology |
207R00000X | Internal Medicine Physician |
207P00000X | Emergency Medicine Physician |
207Q00000X | Family Medicine Physician |
163W00000X | Registered Nurse |
These taxonomies represent the specialties commonly involved in administering or supervising intravenous push injections in facility or office settings.
Related Diagnoses
-
R07.9- Chest pain, unspecified- Relevant when intravenous medications are administered to address acute chest pain, such as nitroglycerin or analgesics.
-
R11.2- Nausea with vomiting, unspecified- Used when intravenous antiemetics are given to treat nausea and vomiting.
-
I10- Essential (primary) hypertension- Applicable when intravenous antihypertensive agents are administered for elevated blood pressure.
-
E87.6- Hypokalemia- Relevant for intravenous potassium replacement therapy.
-
J44.1- Chronic obstructive pulmonary disease with (acute) exacerbation- Used when intravenous medications, such as corticosteroids or bronchodilators, are administered during an acute COPD exacerbation.
Each diagnosis code represents a clinical scenario where an intravenous push injection may be indicated and coded with 96374.
Related CPT Codes
-
96375: Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of a new substance/drug- Used when a second, different substance or drug is administered via intravenous push after the initial injection coded as
96374. Commonly reported together when multiple drugs are given sequentially.
- Used when a second, different substance or drug is administered via intravenous push after the initial injection coded as
-
96376: Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of the same substance/drug provided in a facility- Used when an additional dose of the same substance or drug is administered via intravenous push in a facility setting after the initial injection coded as
96374. Often used in hospital outpatient departments.
- Used when an additional dose of the same substance or drug is administered via intravenous push in a facility setting after the initial injection coded as
Both 96375 and 96376 are related to 96374 as they represent subsequent injections following the initial intravenous push. They are commonly used together in workflows involving multiple or repeated drug administrations.
National Reimbursement Benchmarks
Nationally, the mean rate for CPT code 96374 is highest among commercial payers, with Cigna and UnitedHealth Group both averaging over $70.00. Blue Cross Blue Shield and Aetna are slightly lower, while the BUCA composite mean rate stands at $61.73. In contrast, Medicare's mean rate is significantly lower at $39.33, highlighting a substantial gap between government and commercial reimbursement levels.
Rate dispersion varies notably across payers. Medicare exhibits the tightest range, with its 75th percentile only $5.00 above the 25th percentile, indicating minimal variation. Cigna and UnitedHealth Group show the widest spreads, with Cigna's range reaching $39.00 and UnitedHealth Group's at $36.50, reflecting greater variability in commercial payment rates. Aetna, Blue Cross Blue Shield, and BUCA display moderate dispersion.
The table and chart below present a detailed breakdown of national mean rates and percentile values for each payer.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.