CPT 96379 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 • 99 - Other POS |
| Common Modifiers | • None • SS - Home infusion services provided in the infusion suite of the IV therapy provider • UD |
| Complexity Level | Low |
National average reimbursement for CPT 96379 by major payers:
$54.78
$58.85
$53.75
$32.20
| 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 96379 | ||||||
United | 96379 | $115.37 | 1841442274 - OKLAHOMA HEART HOSPITAL SOUTH LLC | 261131647 - (OK) OKLAHOMA HEART HOSPITAL SOUTH LLC | OK | General Acute Care Hospital (282N00000X) |
United | 96379 | $210.58 | 1902352008 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH CANCER INST-SPARTANBURG | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 96379 | $145.38 | 1912303579 - PRIME HEALTHCARE SERVICES BLUE SPRINGS, LLC, ST. MARY'S MEDICAL CENTER | 472264005 | MO | General Acute Care Hospital (282N00000X) |
United | 96379 | $55.88 | 1760714497 - SAVOY MEDICAL MANAGEMENT GROUP, INC., SAVOY PHYSICIAN SERVICES | 800202027 - (LA) SAVOY MEDICAL MANAGEMENT GROUP INC | LA | General Acute Care Hospital (282N00000X) |
United | 96379 | $134.52 | 1285295899 - AHN EMERUS WESTMORELAND LLC, AHN MCCANDLESS NEIGHBORHOOD HOSPITAL | 823697883 - (PA) AHN EMERUS WESTMORELAND LLC | PA | General Acute Care Hospital (282N00000X) |
United | 96379 | $163.50 | 1548322720 - NORTHEASTERN PENNSYLVANIA HEALTH CORPORATION, HAZLETON GENERAL HOSPITAL | 232421970 - (PA) NORTHEASTERN PENNSYLVANIA HEALTH CORPORATION | PA | General Acute Care Hospital (282N00000X) |
United | 96379 | $56.90 | 1144274127 - PROGRESSIVE ACUTE CARE DAUTERIVE, LLC, DAUTERIVE HOSPITAL | 364756243 - (LA) PROGRESSIVE ACUTE CARE DAUTERIVE LLC | LA | General Acute Care Hospital (282N00000X) |
United | 96379 | $210.58 | 1679029771 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH CANCER INST-EASTSIDE | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 96379 | $210.58 | 1144775032 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH OP SURGERY PATEWOOD | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 96379 | $99.86 | 1336378132 - ROTHMAN ORTHOPAEDIC SPECIALTY HOSPITAL, LLC, BUCKS COUNTY SPECIALTY HOSPITAL, LLC | 270260289 - (PA) ROTHMAN ORTHOPAEDIC SPECIALTY HOSPITAL LLC | PA | General Acute Care Hospital (282N00000X) |
United | 96379 | $143.21 | 1164427431 - ESSENT HEALTHCARE, NASHOBA VALLEY MEDICAL CENTER | 274157855 | MA | General Acute Care Hospital (282N00000X) |
United | 96379 | $128.86 | 1699726695 - NORTHWEST ARKANSAS HOSPITALS, LLC, NORTHWEST MEDICAL CENTER | 205896848 | AR | General Acute Care Hospital (282N00000X) |
United | 96379 | $238.66 | 1063711562 - MULTICARE HEALTH SYSTEM, MULTICARE IMAGING | 911352172 - MULTICARE HEALTH SYSTEM | WA | Radiology Clinic/Center (261QR0200X) |
United | 96379 | $112.79 | 1255346961 - ST. JOSEPH MERCY PORT HURTON | 472361878 | MI | General Acute Care Hospital (282N00000X) |
United | 96379 | $210.58 | 1629432869 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH OP SURGERY SPARTANBURG | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
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 96379 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 96379 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 96379 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 |
|---|---|---|
| 96379-CPT | Low | Unlisted Therapeutic, Prophylactic, Or Diagnostic Intravenous Or Intra-Arterial Injection Or Infusion |
| 96405-CPT | Low | Chemotherapy Administration, Intralesional |
| 96406-CPT | Low | Chemotherapy Administration, Intralesional; More Than 7 Lesions |
| 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 96379. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 96379 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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