2025 CPT code 96372
Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular.
Modifiers may be applicable in certain circumstances. Modifier 59 may be used if the injection is a distinct procedural service from other procedures performed on the same day.Consult the CPT manual and payer guidelines for additional modifier rules.
Medical necessity for this code will be determined based on the patient's diagnosis, the appropriateness of the medication, and the absence of other effective treatment options.Documentation should clearly support the clinical indication for the injection.
The physician or other qualified healthcare professional is responsible for overseeing the entire process, including assessment, treatment planning, and direct supervision of staff administering the injection.The administration itself may be performed by a nurse or assistant under direct supervision.
In simple words: This code covers giving a shot (injection) of medicine under the skin or into a muscle.The medicine could be for treatment, prevention, or diagnosis. It does not include vaccines, cancer treatments, or certain hormone injections.
This CPT code encompasses the administration of a therapeutic, prophylactic, or diagnostic injection of a specified substance or drug via the subcutaneous or intramuscular route.It excludes the administration of vaccines/toxoids, antineoplastic hormonal therapy, and anti-neoplastic nonhormonal injection therapy.The injection must be performed under the direct supervision of a physician or other qualified healthcare professional.Additional codes may be necessary for the administration of multiple substances or drugs or for subsequent injections.
Example 1: A patient receives an intramuscular injection of a corticosteroid for a flare-up of rheumatoid arthritis., A patient receives a subcutaneous injection of a biologic medication for treatment of psoriasis., A patient receives a subcutaneous injection of vitamin B12 for treatment of a deficiency.
Detailed documentation should include the date and time of the injection, the substance or drug administered (including dosage and route of administration), the site of injection, and any patient reactions or adverse events.The physician's order and the treatment plan should also be documented.
** When billing for multiple injections of the same substance on the same date, use the appropriate add-on codes to reflect the additional injections. If the injection is part of a larger procedure, do not bill this code separately.The specific substance or drug must be documented on the claim form.
- Revenue Code: P6C (Medicare Fee Schedule: MINOR PROCEDURES - OTHER)
- RVU: This information is not available in the provided source. RVUs vary by location and payer.
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier does not typically apply to this code.
- Fee Schedule: This information is not available in the provided source. Fee schedules vary by payer and geographic location.
- Specialties:This code is used by numerous medical specialties.Examples include Rheumatology, Dermatology, Endocrinology, and Family Medicine.
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center, Other Place of Service