CPT code 96370: Subcutaneous infusion, each additional hour2026 Medicare rate & RVUs in Texas
Report an additional hour when a therapeutic, prophylactic, or diagnostic medication continues by subcutaneous infusion beyond the initial service.
Medicare pays $16.05–$17.63 for 96370 in the office in Texas, from Beaumont, TX to Austin, TX. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
Your location
On this page 9 sections
What 96370 covers
This add-on represents additional time for a medication delivered by continuous subcutaneous infusion, typically through an infusion pump and subcutaneous site. It is used in office or outpatient care when the infusion continues beyond the initial hour represented by 96369. Clinical staff commonly perform the infusion under physician supervision as an incident-to service.
Report it with 96369, the primary subcutaneous infusion service, only when documented infusion time extends more than 30 minutes beyond the initial hour. Record the medication, subcutaneous route, start and stop times, total infusion duration, and relevant pump or site details. CMS treats 96370 as an add-on paid within the primary procedure's global period. It is billed only when performed under physician supervision; it is not a separate professional or technical component.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 96370 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$16.05 to $17.63
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | $17.63 | Unavailable |
| Beaumont, TX | $16.05 | Unavailable |
| Brazoria, TX | $16.91 | Unavailable |
| Dallas, TX | $17.00 | Unavailable |
| Fort Worth, TX | $16.90 | Unavailable |
| Galveston, TX | $16.95 | Unavailable |
| Houston, TX | $17.13 | Unavailable |
| Rest of Texas | $16.46 | Unavailable |
How the 96370 rate is calculated
Each of 96370’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 96370
RVUs × geographic indexes × conversion factor
Work0.18
0.18 RVUs× 1.000 GPCI
Practice expense0.32
0.32 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
0.5100
Conversion factor
$33.4009
Medicare rate
$17.03
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 96370
The CMS indicators that decide how 96370 is paid alongside other services.
CMS payment indicators · 96370
Subcutaneous infusion, each additional hour
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 5 | Incident-to service. |
96370 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 96369Subcutaneous infusionInitial, up to one hour
- 96369 represents the initial subcutaneous infusion service, while 96370 represents qualifying additional infusion time beyond that initial service.
- 96371Infusion setupAdditional pump setup or site
- 96371 addresses additional pump setup or infusion sites; 96370 addresses additional infusion duration.
- 96372SC/IM injectionTherapeutic, prophylactic, or diagnostic
- 96372 is for a subcutaneous or intramuscular injection. Use 96370 only when medication is delivered by subcutaneous infusion for additional time.
- 96366IV infusion add-on hourTherapeutic or diagnostic, each additional hour
- 96366 represents additional time for an intravenous infusion. 96370 is for additional time with a subcutaneous infusion.
96370 billing questions
Can 96370 be billed without 96369?
No. It is an add-on for additional subcutaneous infusion time and must be reported with the primary infusion service, 96369.
When does the additional hour qualify?
The documented infusion must extend more than 30 minutes beyond the initial hour. Record actual start and stop times to support the additional time.
How is 96370 different from 96371?
96370 represents additional infusion time. 96371 is for additional pump setup or subcutaneous infusion site work, rather than another hour of infusion.
Is 96370 appropriate for a subcutaneous injection?
No. It represents continuing subcutaneous infusion time. A therapeutic, prophylactic, or diagnostic subcutaneous injection is represented by 96372 when that service is performed.
What supervision is required?
CMS identifies this as an incident-to service, so it is billed only when performed under physician supervision.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
Fee sheets
Put 96370 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Build my fee sheet