2025 CPT code 99601
(Active) Effective Date: N/A Revision Date: N/A Home Health - Home Infusion Procedures and Services Medicine Services and Procedures > Home Health Procedures and Services Feed
Home infusion/specialty drug administration, per visit (up to 2 hours).
Modifiers may apply depending on the circumstances of the visit.Consult your payer's guidelines for appropriate modifier use. Modifier 25 may be used if a significant, separately identifiable EM service is performed in addition to the infusion/administration.
Medical necessity will be established by the physician's order for the home infusion or specialty drug administration.This should be documented in the patient's medical record and should reflect the patient's clinical condition, and the need for home infusion rather than administration in another setting.The documentation must support that the patient requires home-based care due to their condition.
The clinical responsibility includes the provider's arrival at the patient's home, preparation of infusion equipment/supplies, and administration of the infusion or specialty drug.This may involve intravenous lines, pumps, and careful monitoring of the patient's response to the medication.
- Medicine Services and Procedures > Home Health Procedures and Services
- Home Health Procedures and Services
In simple words: This code covers a nurse's visit to a patient's home to give an infusion or special medicine. The visit can last up to two hours.
This CPT code reports home infusion or specialty drug administration for a visit lasting up to two hours.It encompasses the provider's arrival at the patient's home, preparation of infusion equipment and supplies (e.g., intravenous line connected to a pump for administering drugs at a prescribed rate), and administration of the infusion or drug.Additional time beyond the initial two hours is reported using code 99602.
Example 1: A patient receiving chemotherapy at home requires a registered nurse to administer the infusion. The nurse spends 1 hour and 30 minutes preparing the infusion, administering the medication, and monitoring the patient. Code 99601 is used to bill for this service., A patient with a chronic illness requires regular infusions of a specialty medication. The registered nurse visits the patient's home every week for a two-hour infusion. Code 99601 is billed for each visit., A patient needs a 3-hour infusion. Code 99601 is billed for the first 2 hours and code 99602 is billed for the additional hour.
Detailed documentation should include the date and time of the visit, the type and amount of medication administered, the duration of the infusion, any complications encountered, and the patient's response to the medication.Physician orders for the infusion should be included.Appropriate documentation to support medical necessity is crucial.
** The payer's specific guidelines regarding reimbursement for this code should be consulted.Consider the use of modifier 52 (Reduced Services) if the service provided is less than what is usually performed.
- Revenue Code: M4A (HOME VISIT)
- RVU: This information is not provided in the source data.Relative Value Units (RVUs) vary by payer and location. Consult your specific payer's fee schedule for current RVU values and reimbursement rates.
- Global Days: Not applicable.This is not a surgical procedure.
- Payment Status: Active
- Modifier TC rule: Not applicable; this code doesn't involve a technical component.
- Fee Schedule: Historical fee schedule information is not available in the provided sources. This information is payer-specific and changes over time.Consult your payer's historical fee schedules for relevant data.
- Specialties:Registered nurses (RNs) with specialized training in home infusion therapy, Oncology, Hematology
- Place of Service:Home, Assisted Living Facility, Group Home, Custodial Care Facility