CPT 2026 · Infusion/Chemotherapy

CPT 96376

Global ZZZ

Tx/pro/dx inj same drug adon

Effective 2026-04-01 Conv. factor $33.4009

No national RVU

Payment Methodology

Status Indicator

NCCI Partners

ZZZ

Global Period

No national RVU

This code does not have a national work RVU on the current Physician Fee Schedule. Pricing may be carrier-determined, non-covered, or tracked via a separate methodology.

CPT 96376 Billing & Documentation Guide

CPT code 96376 (Tx/pro/dx inj same drug adon) is classified under Infusion/Chemotherapy with a global period indicator of ZZZ. This code uses the No national RVU payment methodology rather than standard RVU-based Physician Fee Schedule pricing. Refer to the methodology notice above for billing implications.

When billing 96376, 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 96376 with related codes; this code has 10 PTP bundling relationships on file (see table below).

Payment Status & Global Period

CMS Status Indicator

Statutory exclusion

Global Period

ZZZ

Add-on code (global concept does not apply)

MUE Limit (Medically Unlikely Edits)

Max units per beneficiary per date of service

Rationale: CMS Policy

Adjudication: Date of Service (Clinical)

Source: CMS NCCI MUE Practitioner Services, effective 2026-04-01.

Submitting more than 0 units of 96376 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.

NCCI Bundling Edits, CPT 96376

Procedure-to-procedure (PTP) edits. If you bill any of these codes with 96376 on the same date of service, review the modifier indicator and payer policy before submission.

Partner Code	Relationship	Modifier Allowed	Rationale
36000	Column 1 (primary), can be billed with modifier	Yes	Standards of medical/surgical practice
36591	Column 1 (primary), can be billed with modifier	No	CPT Manual or CMS manual coding instruction
36592	Column 1 (primary), can be billed with modifier	No	CPT Manual or CMS manual coding instruction
66987	Column 1 (primary), can be billed with modifier	Yes	Misuse of Column Two code with Column One code
96523	Column 1 (primary), can be billed with modifier	No	CPT Manual or CMS manual coding instruction
99354	Column 1 (primary), can be billed with modifier	Yes	CPT Manual or CMS manual coding instruction
99354	Column 1 (primary), can be billed with modifier	Yes	CPT Manual or CMS manual coding instruction
99355	Column 1 (primary), can be billed with modifier	Yes	CPT Manual or CMS manual coding instruction
99355	Column 1 (primary), can be billed with modifier	Yes	CPT Manual or CMS manual coding instruction
99358	Column 1 (primary), can be billed with modifier	Yes	CPT Manual or CMS manual coding instruction

Frequently Asked Questions, CPT 96376

What does CPT code 96376 mean? +

CPT code 96376 represents: Tx/pro/dx inj same drug adon. It's in the Infusion/Chemotherapy category with a global period of ZZZ.

What is the Medicare reimbursement for CPT 96376? +

This code does not have a national work RVU on the current Physician Fee Schedule. Pricing may be carrier-determined, non-covered, or tracked via a separate methodology.

What modifiers can I use with CPT 96376? +

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 96376? +

This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.