Infusion Center CPT Codes and Modifiers for 2025
May 14, 2025
Infusion centers manage a wide variety of treatments—from antibiotics and hydration to chemotherapy and biologic therapies. Correct use of Infusion CPT codes and modifiers for 2025 is crucial to ensure accurate billing, maximize revenue, and stay compliant with complex payer rules.
Initial Infusion Services
| CPT Code | Description |
|---|---|
| 96365 | IV infusion, therapy/prophylaxis/diagnosis, initial, up to 1 hour |
| 96360 | Hydration infusion, initial, up to 1 hour |
| 96413 | Chemotherapy infusion, initial, up to 1 hour |
| 96401 | Chemotherapy subcutaneous or intramuscular administration |
Additional Hours and Concurrent Infusions
| CPT Code | Description |
|---|---|
| 96366 | Each additional hour, therapeutic infusion |
| 96361 | Each additional hour, hydration infusion |
| 96415 | Each additional hour, chemotherapy infusion |
| 96368 | Concurrent infusion during primary service |
IV Push and Injection Services
| CPT Code | Description |
|---|---|
| 96374 | Therapeutic IV push, single/initial substance |
| 96375 | Each additional IV push, sequential substance |
| 96372 | Therapeutic injection, IM or subcutaneous |
Common Drug Administration Scenarios
| Scenario | Example | Coding Approach |
|---|---|---|
| Antibiotic infusion | IV ceftriaxone | 96365 (+96366 if >1 hr) |
| Hydration infusion | IV normal saline | 96360 (+96361 if >1 hr) |
| Chemotherapy infusion | IV rituximab | 96413 (+96415 if >1 hr) |
| IV push steroid | IV methylprednisolone | 96374 |
Infusion Billing Modifiers
| Modifier | Description |
|---|---|
| -59 | Distinct procedural service |
| -91 | Repeat lab or diagnostic test |
| -25 | Significant, separately identifiable E/M service |
| -JW | Drug amount discarded |
| -JG | Drug acquired at 340B discounted price |
Common ICD-10 Codes for Infusion Centers
| ICD-10 Code | Description |
|---|---|
| Z51.11 | Encounter for chemotherapy |
| Z51.12 | Encounter for immunotherapy |
| Z51.81 | Encounter for therapeutic drug administration |
| E86.0 | Dehydration |
| J44.1 | COPD with acute exacerbation |
| M05.79 | Rheumatoid arthritis with organ involvement |
| R50.9 | Fever, unspecified |
Infusion Billing Tips for 2025
- Bill chemotherapy first, then therapeutic infusions, then hydration.
- Use -59 when services are distinct (e.g., separate IV lines or substances).
- Document infusion start/stop times carefully to support duration codes.
- Always use -JW for drug wastage reporting where applicable.
- Hydration must be medically necessary and well-documented.
Final Thoughts
Infusion billing is detailed and time-sensitive. Correct use of Infusion CPT codes and modifiers for 2025 ensures you capture every minute of service, justify all billed medications, and optimize revenue while maintaining strict compliance standards.
For informational purposes only.
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