2025 CPT code 99602
(Active) Effective Date: N/A Revision Date: N/A Medicine - Home Health Procedures and Services Medicine Services and Procedures > Home Health Procedures and Services Feed
Home infusion/specialty drug administration; each additional hour (beyond the first 2 hours reported with 99601).
Modifiers may be applicable depending on the circumstances of the service. Consult the CPT manual and payer guidelines for appropriate modifier usage.
Medical necessity is established when the patient's condition requires home infusion or specialty drug administration, and the services provided are consistent with accepted medical standards and guidelines. Appropriate documentation is essential to support medical necessity.
The clinical responsibility involves preparing and administering the infusion or specialty drug at the patient's home, including monitoring the patient's response to the treatment and addressing any complications that may arise during the procedure.
- Medicine Services and Procedures > Home Health Procedures and Services
- Home Health Procedures and Services
In simple words: This code is for extra time spent at home giving a patient an infusion or special medicine. It's only used if the visit is longer than two hours. The first two hours are billed with a different code.
This CPT code reports each additional hour of home infusion or specialty drug administration beyond the initial two hours, which are reported using CPT code 99601.The service includes preparation of infusion equipment or administration supplies at the patient's home.This may involve using an intravenous line connected to a pump to administer the drug at the prescribed rate and duration.This code is an add-on code and requires 99601 to be billed for the first two hours of the visit.
Example 1: A patient receiving chemotherapy at home requires an additional hour of nursing care beyond the initial two hours covered by CPT code 99601. Code 99602 is used to bill for this additional hour., A patient with a central venous catheter needs three hours of home nursing for administering a specialty medication. The first two hours are billed with 99601, and an additional hour is billed with 99602., A patient receiving intravenous antibiotics at home requires an extra 30 minutes for medication administration, flush, and patient education. The entire procedure exceeded 2 hours, the additional time is billed using 99602.
Documentation should include the total time spent providing the infusion or drug administration, a description of the services provided, the medication administered, patient response, and any complications or adverse events.Detailed notes on patient education should also be documented.
** Payers may have specific requirements for documentation and billing. Always refer to the payer's specific guidelines.
- Revenue Code: M4A (Home Visit)
- RVU: The RVUs for this code will vary based on several factors, including geographic location and payer.Consult your specific payer's fee schedule for the most accurate information.
- Global Days: Not applicable. This is an add-on code for additional time beyond the initial two hours.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Fee Schedule: Fee schedules vary by payer and geographic location.Historical fee data can be obtained from previous payer fee schedules.
- Specialties:Home health care, oncology, infusion therapy
- Place of Service:Home, Assisted Living Facility, Group Home, Custodial Care Facility, Non-traditional Private Homes, Schools