$34.52–$38.39
96374 covers an IV push, including drug administration lasting 15 minutes or less. Use 96365 for a qualifying nonchemotherapy drug infusion lasting more than 15 minutes.
On this page
CMS RVU26D · Effective 2026-10-01
96365 IV drug infusion Medicare reimbursement rates in Georgia
Report the initial hour of a nonchemotherapy IV drug infusion lasting more than 15 minutes for treatment, prevention, or diagnosis. Compare 96365 office and facility rates across CMS payment localities in Georgia.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 96365 in Georgia?
Georgia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$61.04–$68.37
2 of 2 localities have a supported rate.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Drug administration
About 96365: Initial nonchemotherapy IV drug infusion, first hour
Report the initial hour of a nonchemotherapy IV drug infusion lasting more than 15 minutes for treatment, prevention, or diagnosis.
This code covers the initial hour of a therapeutic, preventive, or diagnostic IV drug infusion, such as an IV antibiotic or iron infusion lasting more than 15 minutes. Infusion nurses or other clinical staff commonly perform it in physician offices and infusion suites. IV access, routine flushes, tubing, and monitoring are included in the administration service. Staff document the drug, dose, route, and infusion start and stop times.
Select the initial administration code using the drug administration hierarchy, not simply the drug given first or the visit’s chief reason. Usually, one initial administration service is reported per encounter; a protocol requiring distinct IV sites may support another. Report 96366 when the same infusion reaches 91 minutes, 96367 for a subsequent infusion of a different drug, or 96368 for a concurrent infusion when each code’s requirements are met. Report the drug supply separately when applicable. Under the CMS incident-to rule, the service is billed only when performed under physician supervision. Most Medicare services for this code are billed in offices.
CMS billing rules for 96365
- Professional and technical components
- Incident-to service: billed only when performed under physician supervision.
Where the value comes from
- Work RVU0.21 · 10%
- Practice expense (office) RVU1.76 · 88%
- Malpractice RVU0.04 · 2%
1.4M
Medicare services in 2024 · #114 by national volume
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.
96365 compared with similar codes
Office rates for Georgia, from the same CMS release.
$30.51–$33.92
96360 covers an initial IV infusion for hydration. Use 96365 for the initial infusion of a qualifying therapeutic, preventive, or diagnostic drug, following the administration hierarchy when both services occur.
$120.59–$135.71
96413 applies to drugs classified for chemotherapy or complex biologic infusion administration. 96365 covers other qualifying drug infusions, such as IV antibiotics or iron.
$27.30–$30.18
96367 is an add-on for a different drug infused sequentially after the initial service. 96365 reports the initial qualifying therapeutic drug infusion.
Compare 96365 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
2 of 2 payment localities
Atlanta →
Office / nonfacility
$68.37
Facility
Unavailable
Rest Of Georgia →
Office / nonfacility
$61.04
Facility
Unavailable
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96365 billing questions
What is the minimum infusion time for this code?
The infusion must last more than 15 minutes. If administration takes 15 minutes or less, report the appropriate IV push code instead; documented start and stop times support the choice.
When do I add 96366?
Add 96366 when the same infusion continues beyond the first hour by more than 30 minutes. The first add-on unit requires at least 91 minutes of total infusion time.
Can I bill 96365 twice on the same day?
Usually only one initial administration service is reported per encounter. Another may be supported by a separate encounter or a protocol requiring distinct IV sites; document the circumstances and use an appropriate distinct-service modifier when required.
Is an office E/M visit separately billable with 96365?
Yes, when a significant, separately identifiable E/M service is documented; append modifier 25 to the E/M code. Routine infusion assessment and monitoring are included in 96365.
How is a second drug given after the first infusion reported?
Report 96367 for a sequential infusion of a different drug lasting more than 15 minutes, or 96375 if the new drug is given by IV push. Use 96368 for a qualifying concurrent infusion.
Should a monoclonal antibody or biologic be billed with 96365?
The administration code depends on the drug’s classification. Infusions classified for chemotherapy or complex biologic administration use codes such as 96413 rather than 96365.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
12,77696203,,Mlt fam grp bhv train ea add,A,,0.12,0.03,,0.02,,0.01,0.16,0.15,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,77796360,,Hydration iv infusion init,A,,0.17,0.82,,0.82,NA,0.01,1.00,1.00,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,77896361,,Hydrate iv infusion add-on,A,,0.09,0.29,,0.29,NA,0.01,0.39,0.39,5,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,77996365,,Ther/proph/diag iv inf init,A,,0.21,1.76,,1.76,NA,0.04,2.01,2.01,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,78096366,,Ther/proph/diag iv inf addon,A,,0.18,0.45,,0.45,NA,0.01,0.64,0.64,5,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,78196367,,Tx/proph/dg addl seq iv inf,A,,0.19,0.69,,0.69,NA,0.01,0.89,0.89,5,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,78296368,,Ther/diag concurrent inf,A,,0.17,0.44,,0.44,NA,0.01,0.62,0.62,5,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00