Reviewed August 21, 2026

CPT 96367 / 96368 — sequential and concurrent additional infusions

Two add-on codes for the second, third, and fourth drug in an infusion encounter. Which one applies turns on a single question — did the drugs run one after another, or at the same time — and the two codes count units by completely different rules.

Quick Answer

What do 96367 and 96368 report?

96367 reports a new drug infused after the previous one finished, through the same IV access, for up to an hour. You report it once for each additional drug.

96368 reports a drug infused at the same time as another, through the same IV access. It is not timed, and you report it once for the whole encounter — once, no matter how many drugs ran together or how long they ran.

Both are add-on codes. Neither can stand alone on a claim, and neither can be the initial service. Something else in the encounter has to carry the initial code first.

About CPT 96367 and 96368

CodeDescriptorStatusHow units are counted
96367 Intravenous infusion, for therapy, prophylaxis, or diagnosis; additional sequential infusion of a new drug or substance, up to 1 hour Add-on (ZZZ global). Requires a primary service. Once per additional drug. A second and third sequential drug are two units.
96368 Intravenous infusion, for therapy, prophylaxis, or diagnosis; concurrent infusion Add-on (ZZZ global). Requires a primary service. Once per encounter. Not per drug, not per hour.

The word doing the work in 96367 is new. If the same drug simply keeps running past the hour, that is not a sequential infusion — it is additional time on the drug you already reported, which is 96366. A sequential infusion requires a different substance.

The word doing the work in 96368 is concurrent. Two bags hanging at once, with overlapping administration times documented in the record, running either through the same venous access site or through two separate lumens of the same multi-lumen catheter — both count as concurrent. What does not count is two genuinely separate access sites, such as a second peripheral IV in the other arm. That is two access sites, and 96368 does not describe it.

What do 96367 and 96368 reimburse?

CodeNon-facilityFacilityTotal RVU
96367 — additional sequential infusion$29.73$29.730.89
96368 — concurrent infusion$20.71$20.710.62

CY2026 national rates; MAC-adjusted locally. Figures are RVU-derived (work + practice expense + malpractice, times the CY2026 conversion factor of $33.4009) and are held in mpfs-admin-rates.json as the source of truth for this site. Facility and non-facility are identical because CMS assigns the same practice-expense RVU to both settings for this code family — a genuine valuation choice, not a data error.

The economics are worth noticing before you code. A concurrent infusion pays once for the encounter no matter how many drugs ran together. Three drugs infused sequentially generate two units of 96367 — roughly $59 — while the same three drugs hung concurrently generate a single 96368 at $20.71. The codes are not interchangeable and you do not get to pick the better-paying one; the clinical administration decides it, and the record has to support what you billed.

One initial code per encounter — the rule underneath everything

Neither 96367 nor 96368 makes sense until you have settled which service is the initial one, because both are add-ons to it. For a single IV access site, an encounter gets exactly one initial code. Not one per drug — one per encounter.

Choosing the initial code — the CPT hierarchy
  1. Chemotherapy outranks everything. If any drug in the encounter meets the AMA chemotherapy administration definition, that drug's administration is the initial code — 96413 for infusion, 96409 for push, 96401/96402 for SC/IM — regardless of which drug was hung first.
  2. Therapeutic, prophylactic, and diagnostic outrank hydration. With no chemo present, a therapeutic drug infusion takes the initial slot (96365) ahead of any hydration.
  3. Infusions outrank pushes, which outrank injections. Within the same tier, the infusion is the initial service.
  4. Hydration is last. 96360 is the initial code only when hydration is the only thing given.

Everything that is not the initial service becomes an add-on: 96367 if it ran sequentially, 96368 if it ran concurrently, 96366 if it is more time on a drug already reported.

This is why the initial code is so often not the first drug on the MAR. A patient who gets an anti-emetic at 09:00 and carboplatin at 09:40 does not get 96365 for the anti-emetic. The carboplatin is chemotherapy, so 96413 is the initial code, and the earlier anti-emetic drops to a sequential add-on.

Sequential or concurrent?

Decision tree — which add-on applies to the additional drug?
  1. Is it a different drug from the one already reported? If no — the same drug simply ran longer — this is not 96367. Report additional time with 96366 (or 96415 under a chemo initial code).
  2. Did it run through the same venous access, or a second lumen of the same catheter? Either one qualifies as concurrent. A genuinely separate site — a second peripheral IV — does not. Do not report 96368 for that; check payer guidance before reporting a second initial code, and document both sites.
  3. Did the two administrations overlap in time? If the record shows the second drug started before the first stopped, that is concurrent → 96368, once for the encounter. If the second started after the first stopped, that is sequential → 96367.
  4. Is the concurrent substance hydration? Hydration running alongside a therapeutic or chemotherapeutic drug is not separately reportable. Do not report 96360, 96361, or 96368 for it.
  5. Did the sequential drug run longer than an hour? 96367 covers up to the first hour. Additional hours of that same sequential drug are reported with 96366 — and only when the extra time runs 31 minutes or more beyond the hour already reported. Thirty minutes or less does not earn a unit.

Two drugs in one bag is not a concurrent infusion. If multiple substances are admixed into a single bag and hung once, that is one infusion, not two running side by side. Report a single administration — the drugs themselves are still reported separately by their own HCPCS codes, but there is no 96368 and no 96367, because only one infusion was administered.

The documentation test. Sequential versus concurrent is decided entirely by start and stop times, and no other part of the record can substitute for them. If the nurse charted “drug B given with drug A” but recorded only one set of times, there is nothing in the chart that distinguishes 96367 from 96368 — and on audit that ambiguity is resolved against the practice. Overlapping times must be visible as times.

How many times may you report each?

This is the single most expensive misunderstanding in this pair, and it runs in both directions.

96367 — per additional drug

  • Second drug given sequentially: 96367 × 1
  • Third drug given sequentially: a second unit, 96367 × 2 in total
  • Each unit must be a genuinely different substance
  • Additional hours of a sequential drug are 96366, not more 96367
  • Watch the MUE ceiling — run the units check before submitting

96368 — once, whatever happened

  • Two drugs running together: 96368 × 1
  • Four drugs running together: still 96368 × 1
  • Concurrent drugs running four hours: still 96368 × 1
  • A second concurrent episode later the same day: still 96368 × 1
  • Reporting 2 or more units is the classic overpayment finding on audit

When to use, and when not to

Use 96367 / 96368 when…

  • An initial administration code is already on the claim for the encounter
  • The additional substance is a different drug from the primary
  • The additional drug went in through the same IV access
  • Start and stop times are documented for every drug
  • The additional drug ran 16 minutes or longer — below that it is a push

Do not use 96367 / 96368 when…

  • There is no primary service on the claim — add-on codes deny without one
  • The additional time is the same drug — that is 96366 or 96415
  • The additional substance is concurrent hydration — not separately reportable
  • The additional drug is chemotherapy under a chemo initial code — use 96417
  • The additional drug ran 15 minutes or less — that is an IV push, 96375
  • You are tempted to report 96368 more than once in a day

Per-payer requirements

Medicare (all MACs). Follows AMA CPT sequencing and the NCCI Policy Manual. One initial code per encounter per access site; add-ons deny without the primary. MACs apply Medically Unlikely Edits to both codes — 96368 in particular is edited tightly, consistent with its once-per-encounter instruction.

Commercial payers. Most adopt CPT sequencing directly, but a number apply their own unit caps on 96367 and will request the administration record when three or more units appear on one claim. Overlapping start and stop times are the evidence that decides a 96368 review.

All payers. The distinguishing documentation is identical everywhere: drug name, route, and a start and stop time for each administration. Everything on this page follows from those timestamps.

Worked examples

Two non-chemo biologics, given back to back 96365 + 96367
Encounter
IVIG infused first, then a separate therapeutic biologic through the same line
Times
Drug A 09:05–11:10 (125 min). Drug B 11:15–12:05 (50 min)
Overlap
None — B starts after A stops. Sequential.
Hierarchy
No chemo present; the longer therapeutic infusion takes the initial slot
Line 1: 96365 × 1 — initial therapeutic infusion, drug A
Line 2: 96366 × 1 — drug A additional hour (125 min crosses 90)
Line 3: 96367 × 1 — drug B, sequential, first hour
96367 appears once, for the second drug. Drug B ran 50 minutes, inside the hour 96367 covers, so no 96366 attaches to it. Had drug B run 95 minutes, the claim would add a second 96366 for drug B's additional hour — not a second 96367.
Pre-medication before chemotherapy 96413 + 96367
Encounter
Anti-emetic infused, then a chemotherapeutic agent, same line
Times
Anti-emetic 08:30–09:00 (30 min). Chemo 09:10–10:40 (90 min)
Overlap
None. Sequential.
Hierarchy
Chemotherapy outranks the therapeutic pre-med regardless of order given
Line 1: 96413 × 1 — initial chemotherapy infusion, up to 1 hour
Line 2: 96415 × 1 — chemo additional hour (90 min)
Line 3: 96367 × 1 — anti-emetic, sequential non-chemo infusion
The drug given first is not the initial code. The anti-emetic went in first but drops to a sequential add-on because chemotherapy outranks it. Coding the pre-medication as 96417 instead of 96367 is a common and reliably denied error — 96417 is for an additional chemotherapy drug, and an anti-emetic is not one.
Two drugs hung together on one line 96365 + 96368
Encounter
Two therapeutic drugs, separate bags, one IV access, running simultaneously
Times
Drug A 13:00–15:00. Drug B 13:20–14:30
Overlap
70 minutes of documented overlap. Concurrent.
Hierarchy
No chemo; drug A is the initial service
Line 1: 96365 × 1 — initial therapeutic infusion, drug A
Line 2: 96366 × 1 — drug A additional hour (120 min)
Line 3: 96368 × 1 — drug B, concurrent
96368 is reported once and is not timed. Drug B ran 70 minutes, but 96368 has no additional-hour add-on — there is no concurrent equivalent of 96366. If a third drug had also run concurrently, the claim would still carry a single 96368.

Common denials and how to fix them

What comes backWhyThe fix
Add-on billed without a primary procedure 96367 or 96368 submitted with no initial administration code on the claim, or the primary was denied and took the add-on with it Confirm an initial code is present and payable for the encounter. If the primary denied, resolve that first — the add-on cannot be appealed on its own.
Service bundled or not separately payable Two initial codes on one encounter. The second initial code should have been an add-on. Rebill with a single initial code chosen by the hierarchy, and the other administration as 96367 or 96368.
Missing or incomplete information No start and stop times, so sequential versus concurrent cannot be established Submit the administration record with times for every drug. This is the top cause of denial in this family and it is a documentation fix, not a coding one.
Units exceed the allowed maximum Most often 96368 reported more than once per encounter Correct to a single unit of 96368. If several drugs ran together, that is still one unit — the code covers the concurrent episode, not each drug.
Sequential add-on denied as duplicate 96367 reported for additional time on the same drug rather than for a new substance Rebill the additional time as 96366 (or 96415 under a chemo initial). Reserve 96367 for a genuinely different drug.

Frequently asked questions

Can 96367 or 96368 ever be the only administration code on a claim?

No. Both are add-on codes and require a primary service in the same encounter. An add-on submitted alone denies for a missing primary procedure, and it cannot be appealed independently — the underlying initial code has to be corrected first.

How many units of 96368 can I report if four drugs ran together?

One. 96368 is reported once per encounter regardless of how many drugs ran concurrently or how long they ran. There is no additional-hour add-on for concurrent infusion, and reporting multiple units is a routine audit finding.

What if a sequential drug runs longer than one hour?

96367 covers up to the first hour of the sequential drug. Additional hours of that same drug are reported with 96366, each additional hour — not with more units of 96367. The usual CPT convention applies to those hours: an extra 31 minutes or more earns a unit, 30 minutes or less does not. A second unit of 96367 means a second additional drug, not more time.

Two drugs ran at the same time through two different lines. Is that 96368?

It depends on what “different sites” means. Two separate lumens of the same multi-lumen catheter are concurrent — report 96368. Two genuinely separate access sites, such as a second peripheral IV in the other arm, are not; check payer guidance before reporting a second initial code, and document both sites clearly.

Two drugs were mixed into one bag. Is that concurrent?

No. Substances admixed into a single bag and hung once are a single infusion. Report one administration code — neither 96367 nor 96368 applies, because only one infusion was given. The individual drugs are still billed separately under their own HCPCS codes.

Do I report 96368 for hydration running alongside a therapeutic drug?

No. Hydration given concurrently with a therapeutic or chemotherapeutic infusion is not separately reportable — not as 96360, not as 96361, and not as 96368. Hydration is only separately billable when it is given on its own and meets the minimum time.

The pre-medication went in before the chemotherapy. Why isn't it the initial code?

Because the hierarchy is not chronological. Chemotherapy administration outranks therapeutic, prophylactic, and diagnostic administration regardless of the order the drugs were given. The chemo carries the initial code and the earlier pre-medication becomes 96367 if it was infused, or 96375 if it was pushed.

Should an additional chemotherapy drug be 96367 or 96417?

96417, if it is genuinely chemotherapy and given sequentially under a chemo initial code. 96367 is the therapeutic-family sequential add-on. The classification follows the AMA chemotherapy administration definition, not whether the patient is an oncology patient — a rescue agent or supportive drug in a chemo regimen is usually therapeutic, and takes 96367.

The additional drug only ran 12 minutes. Is that 96367?

No. An administration of 15 minutes or less is an IV push, not an infusion. A sequential push of a different drug is 96375. The 16-minute floor applies to the additional drug on its own terms, not to the encounter as a whole.

Sources

Editorial review & sourcing
Reviewed by
Erin Rose, CareCost Estimate founder
Methodology
Every billing figure is triangulated against primary sources — FDA labeling, CMS quarterly ASP files, and payer policy documents — and cited inline. See our methodology and editorial policy.
Last reviewed
May 23, 2026
Update triggers
AMA CPT manual annual revision, NCCI manual update, CPT Assistant clarification, MAC LCD change, reader-reported correction.
Independence
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Spotted an error?
Email editorial@carecostestimate.com. Confirmed corrections normally ship within five business days and are recorded in the public change log.