CPT 96371 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Medicine Services and Procedures • Hydration, Therapeutic, Prophylactic, Diagnostic Injections and Infusions, and Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration |
| Common Place of Service | • 11 - Office • 20 - Urgent Care Facility |
| Common Modifiers | • None • 59 - Distinct Procedural Service • XS - Separate Structure |
| Complexity Level | Low |
National average reimbursement for CPT 96371 by major payers:

$92.88

$88.08

$80.15

$115.95
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 96371 | ||||||
United | 96371 | $116.12 | 1376001701 - SAMANTHA PATEL | 911780160 | IL | Psychiatry Physician (2084P0800X) |
United | 96371 | $105.13 | 1225211600 - JOHN MILLICHAP | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | CO | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 96371 | $131.25 | 1285715847 - SHANNON JENNINGS | 362604009 - (IL) OTTAWA REGIONAL HOSPITAL & HEALTHCARE CENTER | MS | Psychiatry Physician (2084P0800X) |
United | 96371 | $161.55 | 1629335260 - DIVYA DESAI | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 96371 | $107.86 | 1699194480 - JONATHAN KAPLAN | 911780160 | GA | Psychiatry Physician (2084P0800X) |
United | 96371 | $89.90 | 1720532773 - ADULT AND PEDIATRIC NEUROLOGY | 813062689 - (IL) ADULT AND PEDIATRIC NEUROLOGY | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 96371 | $80.54 | 1053349969 - CHRISTEL LEMBKE | 362709982 - (IL) PRESENCE BEHAVIORAL HEALTH | IL | Psychiatry Physician (2084P0800X) |
United | 96371 | $100.52 | 1710206545 - NEIL JARIWALA | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | TX | Psychiatry Physician (2084P0800X) |
United | 96371 | $104.98 | 1215968755 - STACEY OCCOMY | 611630276 - FRANCISCAN PHYSICIAN NETWORK | IL | Psychiatry Physician (2084P0800X) |
United | 96371 | $174.38 | 1518037126 - MARY LAKE | 364187449 | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 96371 | $172.13 | 1770014920 - JOSEPH PEPITONE | 363738206 - NORTHSHORE UNIVERSITY HEALTHSYSTEM FACULTY PRACTICE ASSOCIATES | VT | Psychiatry Physician (2084P0800X) |
United | 96371 | $108.41 | 1871054817 - ERIC ZIMMERMAN | 376000511 - THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS | IL | Psychiatry Physician (2084P0800X) |
United | 96371 | $72.46 | 1245473669 - JILLIAN HOCHFELDER | 133595755 - EZRAS CHOILIM HEALTH CENTER INC | NY | Allergy & Immunology Physician (207K00000X) |
United | 96371 | $72.78 | 1003258260 - SHELI ERSPAMER | 134000192 - ENT AND ALLERGY ASSOCIATES, LLP | NY | Audiologist (231H00000X) |
United | 96371 | $105.87 | 1639276009 - BRUCE EDELMAN | 134000192 - ENT AND ALLERGY ASSOCIATES, LLP | NJ | Pediatric Otolaryngology Physician (207YP0228X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 96371 vs. Other Hydration, Therapeutic, Prophylactic, Diagnostic Injections and Infusions, and Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration Codes
The CPT 96371 code is part of the Medicine Services and Procedures services used for Hydration, Therapeutic, Prophylactic, Diagnostic Injections and Infusions, and Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 96371 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 96370-CPT | Low | Subcutaneous Infusion For Therapy Or Prophylaxis (Specify Substance Or Drug); Each Additional Hour (List Separately In Addition To Code For Primary Procedure) |
| 96371-CPT | Low | Subcutaneous Infusion For Therapy Or Prophylaxis (Specify Substance Or Drug); Additional Pump Set-Up With Establishment Of New Subcutaneous Infusion Site(S) (List Separately In Addition To Code For Primary Procedure) |
| 96372-CPT | Low | Therpeutic, Prophylactic Or Diagnostic Injection {Specify Substance Or Drug}; Subcutaneous Or Intramuscular Nurse Pracitioner Rendering Service In Collaborati |
| 96416-CPT | Moderate | Chemotherapy Administration, Intravenous Infusion Technique; Initiation Of Prolonged Chemotherapy Infusion (More Than 8 Hours), Requiring Use Of A Portable Or Implantable Pump |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 96371. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 96371 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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