September 30, 2025
Accurate coding is essential for proper reimbursement, especially for procedures like injections. One of the most common codes used is CPT code 96372, which applies to therapeutic, prophylactic, and diagnostic injections. Below is a complete breakdown of its meaning, usage, documentation, and billing guidelines.
CPT 96372 is used to report the administration of a subcutaneous (SC) or intramuscular (IM) injection. It refers only to the act of giving the injection, not the medication itself. The drug or substance administered is billed separately.
96372 CPT code description:
Administration of a therapeutic, preventive, or diagnostic medication by either subcutaneous or intramuscular injection, with the specific drug documented.
You should bill 96372 when:
To avoid claim denials, your documentation should clearly include:
Reimbursement for CPT 96372 depends on the payer, region, and whether the service is part of a bundled payment model. On average:
Always verify with the 96372 CPT code fee schedule specific to your location or payer.
Sometimes modifiers are necessary for accurate billing:
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Drugs administered under CPT 96372 must be reported separately using their NDC code. Always:
When submitting the claim, make sure to specify the type of medication or substance injected, along with the correct administration route.
Per CMS (Centers for Medicare & Medicaid Services) regulations, claims should include both the HCPCS drug code and CPT 96372 to ensure proper reimbursement.
The 96372 CPT code plays a crucial role in medical billing for injections. By ensuring complete documentation, using the correct modifiers, and billing the drug separately, providers can maximize reimbursement and avoid claim denials.
Need expert help with injection billing or CPT code compliance? Contact Cures Medical Billing today and let our specialists streamline your revenue cycle.
The CPT code for intramuscular (IM) injection is 96372.
No, CPT 96372 covers only the administration of the injection. The drug must be billed separately.
Yes, but only if the office visit is significant and separately identifiable, in which case modifier 25 may be used.
Yes, if multiple injections are administered, you may report 96372 for each injection. However, proper modifiers (such as 59) and documentation are required to avoid denials.
No, prior authorization is required for the injection administration code itself. However, prior authorization may be needed for the drug being injected.
No, vaccines are billed using their own administration codes (e.g., 90471–90474). CPT 96372 is not used for vaccine administration.
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