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    OpenPayerBilling CodesTherapeutic, Prophylactic, and Diagnostic Injections and Infusions (Excludes Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration)CPT cpt-96370-subcutaneous-infusion-additional-hour
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    CPT 96370: Subcutaneous Infusion Per Additional Hour

    Medicare pays $18 on average nationally for this procedure.

    CPT code 96370 describes infusion of a medication through a previously established subcutaneous infusion site and pump for each additional hour, a therapeutic or preventive drug administration service typically provided in outpatient infusion centers, home infusion settings, or long-term care where a subcutaneous pump and access site are already in place; this code is used to report per-hour ongoing subcutaneous infusion after the initial setup and drug administration has been completed.

    For related coverage guidance, see recent payer policy updates: Percutaneous Electrical Nerve Field Stimulation for Functional Abdominal Pain Disorders, Esophagogastroduodenoscopy (EGD) Coverage Policy, Radiofrequency Therapy for Fecal Incontinence.

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult receiving a continuous subcutaneous infusion pump (for example, for parenteral hydration, analgesic infusion, or antiemetic therapy) who requires extension of an ongoing infusion beyond the initial hourly period. The patient presents to an outpatient infusion clinic, home health nurse visit, or hospital unit where a previously established subcutaneous infusion site and pump are already in place. The provider assesses the existing infusion site and pump set-up, confirms the medication and infusion rate, and documents continuation of the infusion for each additional hour using the existing access. The workflow includes verifying patient identity and orders, inspecting the infusion site and pump tubing for integrity, confirming that no new venous access is required, adjusting the pump to continue infusion for another hour block, and documenting time-based service, medication administered, and clinical rationale in the medical record. Typical settings include outpatient infusion centers, home health visits, hospice care, and inpatient units where the infusion site was established earlier and continuation is medically necessary.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    96365Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hourOften performed prior to or instead of subcutaneous infusion when IV access is used; initial time-based infusion code for the first hour
    96366Intravenous infusion, each additional hour (List separately in addition to code for primary service)Analogous IV additional-hour code; conceptually similar to 96370 but for IV access
    96372Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscularUsed for single subcutaneous injections rather than continued pump infusion; may be reported for separate bolus injections
    96374Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance/drugFor IV push medications that may be given before establishing prolonged infusion
    99199Unlisted special service, procedure or reportOccasionally used when a specific infusion service does not map to standard codes; use with caution and appropriate documentation

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    390200000X
    208000000X
    207RH0000X
    174400000X
    225XN1300X
    225XG0600X
    246QM0900X
    261QG0250X

    Related ICD-10-CM Codes

    29 rows

    ICD-10-CM CodeDescription
    A41.9Sepsis, unspecified organism
    B20Human immunodeficiency virus [HIV] disease
    C34.90Malignant neoplasm of unspecified part of unspecified bronchus or lung
    C50.912Malignant neoplasm of unspecified site of left female breast
    C71.9Malignant neoplasm of brain, unspecified
    D50.9Iron deficiency anemia, unspecified
    D64.9Anemia, unspecified
    E03.9Hypothyroidism, unspecified
    E10.10Type 1 diabetes mellitus with ketoacidosis without coma
    E11.65Type 2 diabetes mellitus with hyperglycemia

    Showing 1–10 of 29

    Related Payer Policy Updates

    Specialty: Gastroenterology1 / 3

    10 rows

    PolicyPayerEffective Date
    Percutaneous Electrical Nerve Field Stimulation for Functional Abdominal Pain Disordersbcbsvermont2026-12-01
    Esophagogastroduodenoscopy (EGD) Coverage Policyevicore2026-11-05
    Radiofrequency Therapy for Fecal IncontinenceCigna2026-10-15
    Magnetic Sphincter Augmentation for the Treatment of Gastroesophageal Reflux Disease (GERD)univerahealthcare2026-10-15
    High-Resolution Anoscopy (HRA)Premera Bluecross2026-10-01
    Gastroesophageal and Gastrointestinal (GI) Services and ProceduresColorado Rocky Mountain Health Plans2026-10-01
    Serum Testing for Hepatic Fibrosis in the Evaluation and Monitoring of Chronic Liver DiseaseOscar Health2026-10-01
    Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant TestingOscar Health2026-10-01
    Pancreatic Enzyme Testing for Acute PancreatitisOscar Health2026-10-01
    Helicobacter pylori TestingOscar Health2026-10-01

    Related Codes

    CPT-96365-INITIAL-INTRAVENOUS-INFUSION-UP-TO-1-HOUR

    CPT 96365: Initial Intravenous Infusion, Up to 1 Hour

    CPT-96366-ADDITIONAL-HOUR-INTRAVENOUS-INFUSION

    CPT 96366: Additional Hour Intravenous Infusion

    CPT-96367-ADDITIONAL-INTRAVENOUS-INFUSION-DIFFERENT-SUBSTANCE-UP-TO-1-HOUR

    CPT 96367: Additional IV Infusion of Different Medication, Up to 1 Hour

    CPT-96368-CONCURRENT-INTRAVENOUS-INFUSION-MULTIPLE-MEDICATIONS

    CPT 96368: Concurrent Intravenous Infusion of Multiple Medications

    CPT-96369-SUBCUTANEOUS-INFUSION-SETUP-AND-ADMINISTRATION-UP-TO-1-HOUR

    CPT 96369: Infusion Pump Setup with Subcutaneous Port, Up to 1 Hour

    CPT-96371-SUBCUTANEOUS-PORT-SITE-ESTABLISHMENT-AND-INFUSION-PUMP-SETUP

    CPT 96371: Subcutaneous Port Relocation with Infusion Pump Administration

    CPT-96372-SUBCUTANEOUS-INTRAMUSCULAR-INJECTION-THERAPEUTIC-PROPHYLACTIC-DIAGNOSTIC

    CPT 96372: Intramuscular or Subcutaneous Therapeutic Injection

    CPT-96373-ARTERIAL-MEDICATION-ADMINISTRATION

    CPT 96373: Intra-arterial Medication Administration

    CPT-96374-INTRAVENOUS-PUSH-SINGLE-MEDICATION

    CPT 96374: Rapid Intravenous Push Medication Administration

    CPT-96375-SEQUENTIAL-IV-PUSH-NEW-DRUG-ADD-ON

    CPT 96375: IV Push Sequential Drug Infusion (New Drug Add-On)

    Showing 1–10 of 15

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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