2025 CPT code 96411
Chemotherapy administration; intravenous push technique; each additional substance/drug. This add-on code is used for each additional drug administered via IV push after an initial chemotherapy drug.
Modifiers may apply depending on the circumstances of the service.Consult the CPT manual and payer-specific guidelines for appropriate modifier usage.
Medical necessity for 96411 is established by the need for additional medication administration to treat a clinically significant condition, such as managing adverse effects of chemotherapy, addressing emergent clinical issues during treatment, or optimizing therapeutic effect.
The administering physician or qualified healthcare professional is responsible for the safe and effective administration of the chemotherapy drug via intravenous push, including monitoring the patient for adverse reactions and making necessary adjustments.
In simple words: This code is for extra chemotherapy medicine given through an IV using a quick injection.The doctor connects a syringe to the IV and slowly injects the medicine. This is only used if other chemotherapy medicine has already been given through the IV. It is billed separately for each additional medicine.
This CPT code, 96411, represents the administration of each additional chemotherapy drug or other highly complex drug or biologic agent via intravenous push technique.It is an add-on code and must be reported in conjunction with a primary procedure code (96409 or 96413), representing the initial administration of a substance/drug. The intravenous push technique is defined as either an injection where the administering professional remains present for administration and observation, or an infusion lasting 15 minutes or less.This code is reported separately for each additional substance/drug administered via this method.The fluid used to administer the drug is considered incidental and not separately billable.
Example 1: A patient receiving initial chemotherapy via intravenous infusion (96413) requires an additional antiemetic medication to control nausea and vomiting.96411 is reported for the administration of this additional medication via IV push., During a chemotherapy treatment session, a patient experiences a severe allergic reaction requiring the immediate administration of an antihistamine and steroid medication via IV push.96411 would be used for the administration of each additional drug to address the allergic reaction., A patient undergoing chemotherapy develops hypotension requiring the intravenous administration of fluids and vasopressors. The initial fluid administration may be coded under a different CPT code depending on the duration, while the vasopressors would be separately reported using 96411 for each drug administered.
* Documentation of the initial chemotherapy administration (primary code 96409 or 96413).* Detailed documentation of each additional drug administered via IV push, including the name, dosage, and time of administration.* Documentation of the patient's response to each drug administered.* Any necessary patient monitoring details, including vital signs, and any adverse reactions.
** Always refer to the most current CPT manual and payer-specific guidelines for the most up-to-date coding and billing information.This information is for general guidance only and should not be considered a substitute for professional medical billing advice.
- Revenue Code: P7B (ONCOLOGY - OTHER)
- RVU: Not specified in provided text.Refer to CMS for current RVU values.
- Global Days: Not applicable to this add-on code.
- Payment Status: Active
- Modifier TC rule: Not applicable; this is an add-on code.
- Fee Schedule: Historical fee schedule data is not available in the provided text. This information may be found on the CMS website.
- Specialties:Oncology, Hematology
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center