CPT 96361
Global ZZZ ActiveHydrate iv infusion add-on
CPT 96361 Billing & Documentation Guide
CPT code 96361 (Hydrate iv infusion add-on) is classified under Infusion/Chemotherapy with a global period indicator of ZZZ. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.09, a non-facility practice expense RVU of 0.29, and a malpractice RVU of 0.01, a total non-facility RVU of 0.39 and facility RVU of 0.39. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $13.46, though rates vary from $11.5 to $17.48 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 96361, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 96361 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Add-on code (global concept does not apply)
MUE Limit (Medically Unlikely Edits)
Submitting more than 8 units of 96361 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 96361
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.09 | 0.09 |
| Practice Expense RVU | 0.29 | 0.29 |
| Malpractice RVU | 0.01 | 0.01 |
| Total RVU | 0.39 | 0.39 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 96361
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $14.76 | $14.76 | $13.85 - $17.48 | 29 |
| Florida | $13.37 | $13.37 | $12.77 - $13.93 | 3 |
| Georgia | $12.65 | $12.65 | $12.04 - $13.26 | 2 |
| Illinois | $13.02 | $13.02 | $12.37 - $13.57 | 4 |
| Michigan | $12.58 | $12.58 | $12.23 - $12.92 | 2 |
| North Carolina | $12.26 | $12.26 | $12.26 - $12.26 | 1 |
| New York | $14.41 | $14.41 | $12.44 - $15.34 | 5 |
| Ohio | $12.19 | $12.19 | $12.19 - $12.19 | 1 |
| Pennsylvania | $12.88 | $12.88 | $12.21 - $13.54 | 2 |
| Texas | $12.87 | $12.87 | $12.13 - $13.56 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 96361
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 96361 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0543T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0544T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0548T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0567T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0568T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0569T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0570T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0571T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0572T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0573T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 96361
What does CPT code 96361 mean? +
CPT code 96361 represents: Hydrate iv infusion add-on. It's in the Infusion/Chemotherapy category with a global period of ZZZ.
What is the Medicare reimbursement for CPT 96361? +
The 2026 Medicare national average non-facility payment for CPT 96361 is $13.46. Rates range from $11.5 to $17.48 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 96361? +
Medicine section spans a wide range: therapy services use GP/GO/GN (PT/OT/SLP plans of care) and KX (above cap with documentation). Drug administration uses JW (waste) and JZ (no waste). Professional/technical split applies to some diagnostic codes.
What bundling edits apply to CPT 96361? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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