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CPT 96371 Fee Schedule

Last Verified: January 2026

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.

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)
Key FactDetail
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 LevelLow

National average reimbursement for CPT 96371 by major payers:

bcbs

$92.88

uhc

$88.08

aetna

$80.15

cigna

$115.95

Preview provider-level rates for...
For billing codeCPT 96371
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 96371

United
96371$105.871164747333 - LAURA HELFNER134000192 - ENT AND ALLERGY ASSOCIATES, LLPNYAllergy & Immunology Physician (207K00000X)
United
96371$70.611598920787 - MARCIA WARREN134000192 - ENT AND ALLERGY ASSOCIATES, LLPNJAudiologist (231H00000X)
United
96371$107.861699194480 - JONATHAN KAPLAN911780160GAPsychiatry Physician (2084P0800X)
United
96371$123.511295754539 - ARI GOLDSMITH133544120 - CAREMOUNT MEDICAL, P.C.NYPediatric Otolaryngology Physician (207YP0228X)
United
96371$82.101841484862 - NEAL GEHANI134000192 - ENT AND ALLERGY ASSOCIATES, LLPNYOtolaryngology Physician (207Y00000X)
United
96371$52.771669992988 - ASHLEY HELTHALL262916543DEAudiologist (231H00000X)
United
96371$105.871730488941 - MARY PAUL134000192 - ENT AND ALLERGY ASSOCIATES, LLPNYAllergy Physician (207KA0200X)
United
96371$82.101083212518 - LAUREN MCCAULEY134000192 - ENT AND ALLERGY ASSOCIATES, LLPNYAudiologist (231H00000X)
United
96371$110.761003087917 - GREGG GOLDHAGEN264709927 - WESTCHESTER MEDICAL CENTER ADVANCED PHYSICIAN SERVICES, P.CNYAudiologist-Hearing Aid Fitter (237600000X)
United
96371$70.611134558448 - STEFANIE NATELSON134000192 - ENT AND ALLERGY ASSOCIATES, LLPNYAudiologist (231H00000X)
United
96371$70.611609894930 - PAUL BELL134000192 - ENT AND ALLERGY ASSOCIATES, LLPNYOtolaryngology Physician (207Y00000X)
United
96371$104.981124209291 - PETER GIOIA133544120 - CAREMOUNT MEDICAL, P.C.NYAudiologist-Hearing Aid Fitter (237600000X)
United
96371$60.951144390014 - MAYER ADLER113389869 - MAYER ADLER MD, PCNYOtolaryngology Physician (207Y00000X)
United
96371$105.871891157384 - MAYLENE XIE134000192 - ENT AND ALLERGY ASSOCIATES, LLPPASingle Specialty Group (193400000X)
United
96371$104.981215968755 - STACEY OCCOMY611630276 - FRANCISCAN PHYSICIAN NETWORKILPsychiatry Physician (2084P0800X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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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.

CodeComplexityDescription
96370-CPTLowSubcutaneous Infusion For Therapy Or Prophylaxis (Specify Substance Or Drug); Each Additional Hour (List Separately In Addition To Code For Primary Procedure)
96371-CPTLowSubcutaneous 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-CPTLowTherpeutic, Prophylactic Or Diagnostic Injection {Specify Substance Or Drug}; Subcutaneous Or Intramuscular Nurse Pracitioner Rendering Service In Collaborati
96416-CPTModerateChemotherapy 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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