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CPT 96375: Sequential IV Push Infusion, New Drug Add-On
CPT code 96375 captures the sequential administration of one or more different medications by intravenous (IV) push following an initial IV push drug. Nationally, this code matters because it documents a distinct add-on service when clinicians deliver additional IV push medications during a single encounter for treatment, prophylaxis, or diagnostic purposes. Proper use of 96375 affects clinical documentation, billing accuracy, and payment for episodic IV medication administration.
This analysis includes common commercial and federal payers: Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find a concise overview of the code's clinical intent and typical sites of service, a summary of common billing considerations, and context for selecting this add-on code versus related infusion and injection codes. The content highlights how 96375 relates to sequential IV push workflows and clarifies when it is distinct from other infusion and injection services.
The publication provides benchmarks and policy context where available, clarifies coding relationships to related infusion codes, and outlines typical diagnosis pairings associated with use. Data not available in the input will be noted explicitly in relevant sections.
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Billing Code Overview
CPT code 96375 describes the sequential administration of a different medication or medications via intravenous (IV) push following an initial IV push of a drug or substance. The service covers administration for treatment, prophylaxis, or diagnostic purposes when a provider gives one or more additional medications by IV push in sequence after the first IV push medication.
Service type: Therapeutic, prophylactic, or diagnostic sequential IV push infusion (new drug add-on).
Typical site of service: Outpatient clinic, hospital outpatient department, emergency department, or other settings where IV push medications are administered.
National Reimbursement Benchmarks
Commercial averages for BUCA and Medicare diverge notably: BUCA’s mean rate is $65.40 versus Medicare’s mean of $16.40, so BUCA averages about $49.00 higher than Medicare. This underscores a substantial commercial–Medicare gap for CPT 96375, with BUCA positioned near the upper end of national commercial means while Medicare remains tightly clustered around mid-teens.
Dispersion measured by the interquartile range (P75–P25) varies across payers. Blue Cross Blue Shield has a P75–P25 of $51.06, Aetna $53.20, UnitedHealth Group $16.70, Cigna $18.10, and BUCA $37.30; Medicare’s IQR is $2.00. Aetna and Blue Cross Blue Shield exhibit the widest IQRs, indicating greater rate spread, while Medicare, UnitedHealth Group, and Cigna are comparatively tight, with Medicare being the narrowest.