$152.13–$171.70
96369 reports the primary subcutaneous infusion service for up to one hour. Use 96371 for additional pump setup or establishment of a new site during that infusion.
On this page
CMS RVU26D · Effective 2026-10-01
96371 Infusion setup Medicare reimbursement rates in Massachusetts
Reports an additional pump setup or newly established subcutaneous infusion site during a therapeutic, prophylactic, or diagnostic subcutaneous infusion. Compare 96371 office and facility rates across CMS payment localities in Massachusetts.
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 96371 in Massachusetts?
Massachusetts 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
$59.44–$67.40
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 96371: Additional subcutaneous infusion setup
Reports an additional pump setup or newly established subcutaneous infusion site during a therapeutic, prophylactic, or diagnostic subcutaneous infusion.
This add-on captures an additional pump setup or establishment of a new subcutaneous infusion site during a therapeutic, prophylactic, or diagnostic infusion. It represents setup or site work, not additional infusion time. Clinical staff commonly perform the hands-on work in an office or infusion setting.
Report 96371 only with a primary subcutaneous infusion service, such as 96369 or 96370, when the additional setup or site is performed. Document the infusion and the additional pump setup or site established. CMS classifies 96371 as an add-on, billed only with a primary procedure and paid within that procedure’s global period. As an incident-to service, it may be billed only when performed under physician supervision.
CMS billing rules for 96371
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
- Professional and technical components
- Incident-to service: billed only when performed under physician supervision.
Where the value comes from
- Work RVU0.00 · 0%
- Practice expense (office) RVU1.69 · 100%
- Malpractice RVU0.00 · 0%
970
Medicare services in 2024 · #2995 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.
96371 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
$17.63–$19.32
96370 reports qualifying additional infusion time. 96371 reports additional pump setup or a new site, rather than another hour.
$15.88–$17.37
96372 is for a therapeutic, prophylactic, or diagnostic subcutaneous or intramuscular injection. 96371 is an add-on for additional setup or a new site during subcutaneous infusion.
Compare 96371 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
Metropolitan Boston →
Office / nonfacility
$67.40
Facility
Unavailable
Rest Of Massachusetts →
Office / nonfacility
$59.44
Facility
Unavailable
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96371 billing questions
When is 96371 reported with 96369 or 96370?
Report 96371 with a primary subcutaneous infusion service when an additional pump setup or new infusion site is established. The primary infusion code represents the infusion service; 96371 represents the additional setup or site work.
Is 96371 an additional-hour code?
No. It reports additional pump setup or establishment of a new subcutaneous infusion site, not another hour of infusion time. Use 96370 for qualifying additional infusion time.
What documentation supports 96371?
Document the subcutaneous infusion and the additional pump setup or newly established site. The record should make clear what additional setup or site work was performed.
Can 96371 be billed by itself?
No. CMS identifies 96371 as an add-on code that must be billed with a primary procedure, such as 96369 or 96370.
Who may perform the service for billing?
CMS identifies 96371 as an incident-to service. It may be billed only when performed under physician supervision.
How does 96371 differ from 96372?
96371 describes additional setup or a new site during a subcutaneous infusion. 96372 describes a therapeutic, prophylactic, or diagnostic subcutaneous or intramuscular injection.
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.
12,78296368,,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
12,78396369,,Sc ther infusion up to 1 hr,A,,0.21,4.10,,4.10,NA,0.03,4.34,4.34,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,78496370,,Sc ther infusion addl hr,A,,0.18,0.32,,0.32,NA,0.01,0.51,0.51,5,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,78596371,,Sc ther infusion reset pump,A,,0.00,1.69,,1.69,NA,0.00,1.69,1.69,5,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,78696372,,Ther/proph/diag inj sc/im,A,,0.17,0.28,,0.28,NA,0.01,0.46,0.46,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,78796373,,Ther/proph/diag inj ia,A,,0.17,0.41,,0.41,NA,0.01,0.59,0.59,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,78896374,,Ther/proph/diag inj iv push,A,,0.18,0.93,,0.93,NA,0.02,1.13,1.13,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00