96367 is the add-on for a new drug that starts only after the one before it has finished running through the same IV access, up to one hour, billed once for each additional drug. 96368 is the add-on for a drug that is infusing at the same time as another, through a separate bag or line at the same access, billed only once per date of service no matter how many drugs overlap or for how long. Neither code can be the initial service, and neither can stand on the claim alone — both attach to whichever infusion, push or injection already holds the encounter’s one initial-service slot.
The first question is never sequential-or-concurrent. It is whether the additional substance is a new drug at all. A second bag of the identical drug hung to keep an infusion going is not a sequential infusion of anything — it is more time on the drug already reported, and CPT's own instruction for the sequential add-on directs that additional hours of it are billed as 96366, not as a second unit of 96367. Only once the additional substance is genuinely different does the sequential-versus-concurrent question apply.
With a new drug confirmed, the second question is timing. If it started after the first drug's documented stop time, through the same access, it is sequential — 96367, one unit for that drug, covering up to an hour of it. If it started while the first drug was still running — two bags open at once through the same IV access, or two lumens of one multi-lumen catheter — it is concurrent — 96368. CMS is explicit that concurrent status does not multiply with the number of drugs or the clock:
“The CPT includes a code for a concurrent infusion in addition to an intravenous infusion for therapy, prophylaxis or diagnosis. Allow only one concurrent infusion per patient per encounter.” — CMS Pub. 100-04 Ch. 12 §30.5
NCCI states the same once-per-encounter rule for the chemotherapy side of the family, in the section written for a concurrent antiemetic or non-chemotherapeutic drug running alongside chemotherapy:
“CPT code 96368 may be reported with a maximum of one unit of service per patient encounter regardless of the number of concurrently infused drugs or the length of time for the concurrent infusion(s).” — NCCI Policy Manual, Ch. XI §N.6
A second, third and fourth drug all dripping together through the same access is still one 96368 for the whole encounter. A second sequential drug, by contrast, is a second unit of 96367 — the two codes count in opposite ways, which is the detail this pairing gets wrong most often.
Neither add-on is available for hydration running alongside a drug. Fluid infusing at the same time as a therapeutic or chemotherapeutic drug through the same access is not a billable concurrent service, and it does not become one by virtue of running long or being separately ordered. The rule is one sentence in the NCCI manual:
“Hydration concurrent with other drug administration services is not separately reportable.” — NCCI Policy Manual, Ch. XI §B.6
That closes off 96360, 96361 and 96368 alike for the overlapping minutes. Separately necessary hydration is still billable — but only when it runs before or after the drug at a distinct, documented time, in which case it is reported as 96361 (the add-on hour), not 96360 and never 96368, because another drug already holds the initial-service code that encounter.
The Medically Unlikely Edit table treats the two codes differently in kind, not just in number.
| Code | MUE (practitioner) | MUE (facility) | MUE Adjudication Indicator |
|---|---|---|---|
| 96367 | 4 | 4 | 3 — Date of Service Edit: Clinical |
| 96368 | 1 | 1 | 2 — Date of Service Edit: Policy |
96367's MUE of 4 (practitioner and facility, 2026 Q3 and Q4 NCCI table) is an MAI 3 clinical edit — a fifth sequential drug is unusual but the contractor will pay it on appeal with the administration record, because the limit reflects clinical data rather than a hard policy ceiling. 96368's MUE of 1 is MAI 2, a policy edit tied directly to the code's own descriptor and the CMS instruction quoted above: the limit is not a clinical estimate to be argued down, it is the rule. A claim that carries 96368 ×2 — two separate concurrent episodes charted the same day, or a coder trying to bill one unit per concurrently-running drug — denies the second unit as CO-151 with remark N362, units exceeding the MUE, and there is no documentation that reopens an MAI 2 denial the way it would an MAI 3 one. The fix is not an appeal; it is dropping the units to 1.
Swap the ondansetron for a second bag of ceftriaxone at 09:00 and neither add-on applies at all — a second bag of the same drug started before the first one is done is additional time on the same 96365, not a new code.
Both add-ons attach to whichever code holds the initial slot, and a chemotherapy or highly complex biologic infusion (96413) outranks a non-chemo therapeutic infusion (96365) for that slot regardless of which drug was hung first. A non-chemo drug — a steroid, an antihistamine, IVIG — infused sequentially on a 96413 day is still 96367, the non-chemo sequential add-on; it does not become 96417, which CPT's parenthetical reserves for a sequential chemotherapy drug (96417 is reported in conjunction with 96413, for each additional sequential infusion of a different chemotherapeutic substance, up to one hour).
Yes, if both are different from the initial drug and from each other: one unit of 96367 per additional sequential drug, up to the MUE of 4. Two units of the same additional drug is not two sequential infusions; it is additional time on that one drug, billed as 96366.
No. 96368 has no additional-hour add-on and no time component in its unit count — CMS allows one unit per encounter regardless of how long the concurrent infusion or infusions ran (Pub. 100-04 Ch. 12 §30.5). Three hours of concurrent infusion and twenty minutes of concurrent infusion both bill as 96368 ×1.
No. 96367 requires a different substance. A second bag of the same drug, whether it ran sequentially or was simply a continuation, is additional infusion time on the drug already reported — 96366 for each additional hour with 31 or more minutes in it, not a unit of 96367.
Because 96368's MUE carries adjudication indicator 2, a policy edit tied to the code's own descriptor rather than a clinical estimate. An MAI 3 edit like 96367's can be paid on appeal with documentation; an MAI 2 edit like 96368's is treated as an absolute limit, so the fix is dropping the second unit, not appealing it.
Quoted passages are reproduced from the cited federal publications; everything else is our reading of them. The methodology by which we resolve source disagreements is described in the Methodology.