2025 CPT code 96415

Each additional hour of intravenous chemotherapy infusion, beyond the initial hour.

This is an add-on code and must be used in conjunction with 96413. It should not be reported if the additional infusion time is 30 minutes or less.Only one initial service code (e.g., 96365, 96413) should be reported unless protocol requires two separate IV sites.The fluid used to administer the chemotherapy drug is considered incidental hydration and is not separately billable.

Modifiers may be applicable.Commonly used modifiers include 52 (Reduced Services), 53 (Discontinued Procedure), 76 (Repeat Procedure by Same Physician), 77 (Repeat Procedure by Another Physician), and others, as appropriate.

IMPORTANT Use 96415 in conjunction with 96413.

In simple words: This add-on code is used for each additional hour a chemotherapy drug is given into a vein, after the first hour, during the same visit.

Chemotherapy administration, intravenous infusion technique; each additional hour (List separately in addition to code for primary procedure). This code is used to report each additional hour of chemotherapy infusion beyond the initial hour (reported with code 96413). Report 96415 for infusion intervals of greater than 30 minutes beyond 1-hour increments.

Example 1: A patient receives two and a half hours of intravenous chemotherapy infusion. The initial hour is reported with 96413, and the additional one and a half hours are reported with two units of 96415., A patient receives an initial hour of chemotherapy infusion (96413), followed by an additional 45 minutes of infusion. Since the additional infusion time is greater than 30 minutes, it is reported with one unit of 96415., A patient receives chemotherapy infusion for 1 hour and 15 minutes. Only one unit of code 96413 is reported as code 96415 is for infusions lasting more than 1 hour and 30 minutes.

Documentation should include the start and stop times of the infusion, the type of chemotherapy drug administered, the route of administration (intravenous), and any complications or adverse reactions.

  • Revenue Code: P7B - ONCOLOGY - OTHER
  • Specialties:Medical Oncology, Hematology
  • Place of Service:Office, Outpatient Hospital, Inpatient Hospital, and other places of service where chemotherapy is administered.
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