Let’s suppose IV hydration is initiated on a patient, running consecutively and started at 11:45pm on day 1 until 1:20 am on day 2.  That’s one hour and 35 minutes of total running time by the clock, so it’s worth one initial and one additional CPT hour.  But only 15 minutes of this infusion occurred on the first date of service.  Hydration services must be greater than 31 to 60 minutes in duration to code a CPT hour’s worth. 

So what do we do with the 15 minutes infused on day one? 

Would this be coded as 96360 with the DOS of the starting date (when the infusion was initiated) and 96361 with the DOS of the second day after midnight?  Or would it be correct to ignore the service which occurred on day one, as it only ran for 15 minutes for that date of service, and only code 96360 for the second date of service, as only one hour and 20 minutes of infusion occurred on that date?  Or would we capture 96360 and 96361 both on day 2 as that’s when each of the services were completed, ie: the first full hour and the >31 minutes comprising the second hour?

From CMS, there is this:

“Drug administration services are to be reported with a line item date of service on the day they are provided. In addition, only one initial drug administration service is to be reported per vascular access site per encounter, including during an encounter where observation services span more one calendar day.”

From: https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R1702CP.pdf

and similarly -

“Drug administration services are to be reported with a line-item date of services on the day they are provided. In addition, beginning in CY 2007, hospitals should report only one initial drug administration service, including infusion services, per encounter for each distinct vascular access site, with other services through the same vascular access site being reported via the sequential, concurrent or additional hour codes.”

From:  https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R2141CP.pdf

For coding, apply the conventional practice of ascribing the starting time and date as the date the service was initially provided, just as one would do for a surgery CPT, ED visit E/M, etc.  So the answer is:  96360 with DOS 1 (before midnight), and 96361 with DOS 2 (after midnight).



Ed has been in healthcare his entire career with 15 years as a clinician and 11 years in a variety of HIM coding related roles. After 4 years as a respiratory therapist and 11 years as an emergency medicine Physician Assistant, the fascination with reading, analyzing, and translating medical documentation overcame his desire to perform patient care. For a guy who with a habit for reading the Encyclopedia Brittanica, the Merck Manual, and medical records just for fun, HIM became a natural fit.

Documentation and coding audits are firmly in Ed’s skillset but educating coders is what really makes him tick. He is known for effectively integrating anatomy, physiology, pathophysiology, medicine, and detailed procedural descriptions into his coding education in all forms.

He is a BS graduate in Biology from Virginia Commonwealth University and Master of Health Sciences from Duke University. Obsessed with aviation, he has a pilot’s license, 1000 skydives, owned an ultralight for several years, and currently designs, builds, and flies radio controlled airplanes and drones. Ed lives in Virginia with his wife and two kids, and plays outside with them as much as possible.


  1. Beth

    I have a question on how to bill for multiple, separate HYDRATION infusions. (This is not a continuous infusion). iS each separate infusion’’s duration/start & stop time calculated and the appropriate # of units billed, or are the separate time increments added together and units assigned based on the total time? It makes a difference in some instances as to how many units are reported. Thank you.
    If you respond, I would appreciate any regulatory guidance you have as reference. Per the CPT manual it is clear that multiple, separate, THERAPEUTIC infusions are reported with the appropriate CPT code based on the time of each separate infusion, the times are not combined for a total time . It is not exactly clear in The CPT manual if HYdration infusion is included with the guidance for therapeutic infusions.

    • Kate K.

      Hydration services provided at separate intervals may be coded similarly to therapeutic infusions in which each infusion is coded as a separate service according to the duration of each particular hydration infusion.

      For hydration that runs in non-consecutive stretches, like 45 minutes at hour 0 and another 35 minutes at hour 2, the first infusion is >31 minutes therefore 96360 and the second infusion is >31 minutes therefore amounts to an additional hour, so +96361. Were you to add up 45 minutes and 35 minutes, that is 80 minutes, or one 60 minute increment for the initial hour 96360 and 20 minutes remaining, which does not justify +96361. So in this respect, hydration services are like therapeutic infusion in which hydration infusions are reported with the appropriate CPT code based on the time of each separate infusion.

      • Nicole wood

        I was also wondering the same concept. I have an example of a start and stop 600-728 to give a total of 88 mins hydration. (1 unit) Then it starts back up and goes for 28 mins from 803-831. Does that 28 mins get added to the 88 to give 116 mins running time (96360×1 & 96361×1) …can the total time be “added” or is a minimum 31 mins needed like the initial unit which would only give one u it 96360?

        • kkluglein

          In this case only one unit of 96360 may be assigned as the initial infusion does not go past the 91 minute mark. The additional start up of the 28 minutes can not be coded as it also does not pass the 31 minute mark as required per CPT Coding Guidelines. Since the hydration stopped and then was restarted these minutes cannot be added together.

          CPT Assistant, October 2011, Volume 21, Issue 10, Page 3 – “Reporting Guidelines for Time-Based Codes”
          CPT Assistant, May 2011, Volume 21, Issue 5, Page 7 – “Updated Reporting Instruction for Hydration Infusion”
          CPT 2020 Manual – “Instructions preceding CPT code 96360”


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