Reviewed September 19, 2026
96374, 96375 and 96376 with modifier 59: coding multiple IV pushes on the same day
Last reviewed: September 19, 2026 · Source: AMA CPT manual, NCCI Policy Manual 2026 · Methodology
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Quick Answer
96374, 96375 and 96376 with modifier 59: coding multiple IV pushes on the same day
Three pushes on one day are usually one 96374 and add-ons, not three 96374s. 96374 is reported once, as the initial service, when a push is the highest-ranked administration of the encounter. Each additional push of a different drug is 96375. An additional push of the same drug is 96376 — and only in a hospital outpatient department; in a physician office the repeat same-drug push is inside 96374 and is not billed. Modifier 59 is not what makes an add-on payable: 96375 and 96376 attach to 96374 (or to an infusion initial code) without it. Modifier 59 or XU belongs on a push line only when a PTP edit pairs it with another service on the claim, or in the rare case of a second initial code for administrations at separate IV access sites.
What counts as a push, and which push is which
CMS defines an intravenous or intra-arterial push as either an injection where the healthcare professional is continuously present to administer the substance and observe the patient, or an infusion of 15 minutes or less (Pub. 100-04, Ch. 12 §30.5). In practice, the second prong is what separates push from infusion codes for most drug administration: sixteen or more documented minutes is an infusion — 96365 for a non-chemo drug, 96413 for chemotherapy — and the push family does not apply. Without a charted start and stop time, there is no basis to bill the infusion code, so an undocumented administration defaults to a push.
| Code | Reports | How many per day | Setting note |
|---|
| 96374 | Initial IV push, single or initial substance | One, and only when no higher-ranked initial service (96365, 96409, 96413) is on the claim | Office and hospital outpatient |
| 96375 | Each additional sequential push of a new substance | One unit per additional drug | Office and hospital outpatient; add-on, never alone |
| 96376 | Each additional sequential push of the same substance | One unit per repeat push | Hospital outpatient only — in POS 11 the repeat push is inside 96374 |
Where modifier 59 actually belongs
Two different rules get mixed up under “96374 with modifier 59”.
- Add-ons never need it. 96375 and 96376 are “list separately in addition to” codes. They are reported with the initial code and paid as add-ons; appending 59 to them adds nothing and invites a review.
- A second initial code needs it — rarely. NCCI Ch. XI §B.2: “For a patient encounter, only one ‘initial’ service code may be reported unless it is medically reasonable and necessary that the drug or substance administrations occur at separate intravenous access sites. To report 2 different ‘initial’ service codes, use National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP)-associated modifiers.” That is the case for 59 or XU on a push line: a second access site that was itself medically necessary (not a convenience second line), with the reason charted.
- A PTP edit against another service needs it. When a push is legitimately distinct from a procedure or another administration code on the same claim and the edit allows a modifier, 59/XU on the push line breaks the edit. The most common miss is the reverse: a push of contrast or a pre-procedure medication that is integral to the procedure, where no modifier makes it payable (see is 96374 a radiology code?).
Worked claim: three pushes in an office
Solu-Medrol, Benadryl, then InjectaferJ2919 · J1200 · J1439office, POS 11
- Documented
- Methylprednisolone 125 mg IV push 10:00 (3 min). Diphenhydramine 50 mg IV push 10:05 (2 min). Ferric carboxymaltose 750 mg IV push 10:15–10:23 (8 min). No infusion of 16+ minutes on the day.
- Highest-ranked service
- All three are non-chemo pushes — one 96374 for the encounter.
- Additional pushes
- Two more drugs, each different from the others → 96375 × 2.
One initial push, two different-drug add-ons, no modifier 59 anywhere.
J1439 × 750 · JZ
J2919 × 25 (1 unit = 5 mg)
J1200 × 1
96374 × 1
96375 × 2
Add a second Solu-Medrol push at 14:00 for a reaction and the office claim does not change — 96376 is not reportable in POS 11. The same visit in a hospital outpatient department adds 96376 × 1. Move the Injectafer to a 20-minute documented infusion and the initial code becomes 96365, with both remaining pushes as 96375. Priced lines for any of these variants: the Code this visit tool on the IV push page.
Checklist
Bill it this way when…
- Each push is 15 minutes or less, or the clinician stayed continuously present for the whole administration
- One 96374 on the claim, or none when an infusion initial code outranks it
- 96375 for each additional different drug; 96376 only in a hospital outpatient setting
- Modifier 59/XU only on a second initial code at a separate, necessary access site, or to break a real PTP edit
Do not when…
- 96374 reported more than once on the same day
- Modifier 59 appended to 96375 or 96376 to ‘make them pay’
- 96376 in a physician office (POS 11)
- A push of contrast, anesthesia or a pre-procedure drug reported with 59 to get around a procedure bundle
Frequently asked questions
Do I need modifier 59 on 96375 when I bill it with 96374?
No. 96375 is an add-on code reported in addition to the initial service; it is paid on its own line without a modifier. Modifier 59 or XU is reserved for breaking a PTP edit against another service, or for the uncommon second initial code when administrations were medically necessary at separate IV access sites.
Same drug pushed twice in one office visit — can I bill 96376?
Not in a physician office. 96376 is reportable in the hospital outpatient department; in POS 11 the additional same-drug push is included in 96374. The drug itself is still reported for the total amount administered.
What if one of the pushes ran 18 minutes?
Then it is an infusion, not a push. With documented start and stop times of 16 minutes or more the administration is 96365 (or 96413 for chemotherapy), that infusion becomes the initial service of the encounter, and the remaining pushes are reported as 96375 add-ons.
A drug was pushed, then infused later the same day. Two initial codes?
No. The infusion (96365 or 96413) is the initial service and the push is reported as the add-on 96375 (or 96411 in the chemotherapy family). Two initial codes require separate, individually necessary IV access sites and a PTP-associated modifier, per NCCI Ch. XI §B.2.
Sources
- CMS, NCCI Policy Manual for Medicare Services, 2026 edition, Chapter XI (Medicine, CPT 90000-99999), Section B (Therapeutic or Diagnostic Infusions/Injections and Immunizations) and Section N (Chemotherapy Administration). Quoted passages are from the revision dated 1/1/2026.
- CMS, Internet-Only Manual Pub. 100-04 (Medicare Claims Processing Manual), Chapter 12, §30.5 — drug administration services in the physician office, including the definition of an intravenous push.
- AMA CPT Manual (current calendar year), Hydration, Therapeutic, Prophylactic, and Diagnostic Injections and Infusions (96360-96379) and Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration (96401-96549): code descriptors, the initial/sequential/concurrent hierarchy and the parenthetical reporting instructions.
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.
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Methodology
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Last reviewed
September 19, 2026
Update triggers
Annual NCCI Policy Manual revision, quarterly NCCI edit file changes, AMA CPT annual revision, MAC article on the codes discussed, reader-reported correction.
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