Injection and infusion services are frequently billed in outpatient and office settings, and CPT 96372 is one of the most commonly used codes for therapeutic injections. Despite its routine use, incorrect billing of CPT 96372 often leads to denials or reduced reimbursement.

At Billing Care Solutions, we help healthcare providers bill injection services accurately while staying compliant with payer guidelines. This guide explains what CPT 96372 means, when it should be used, and common billing mistakes to avoid.

What Is CPT 96372?

CPT 96372 is used to report the administration of a therapeutic, prophylactic, or diagnostic injection, delivered subcutaneously or intramuscularly.

CPT 96372 Description:

Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular

This code represents the administration only, not the medication itself.

When to Use CPT 96372

CPT 96372 should be billed when:

• A provider administers an IM or subcutaneous injection

• The injection is non-intravenous

• The service is not bundled into another procedure

• The medication is separately reportable

Common Examples:

• Vitamin B12 injections

• Hormonal injections

• Antibiotic injections

• Steroid injections (non-joint)

• Allergy injections (when applicable)

CPT 96372 and Medication Billing

Since CPT 96372 covers administration only, the drug must be billed separately using:

• HCPCS J-codes (e.g., J1100, J3420)

• Correct units based on dosage

Accurate linkage between the injection code and medication is essential.

CPT 96372 and Modifier 25

In many cases, CPT 96372 is billed on the same day as an E/M visit.

• Modifier 25 may be required on the E/M code

• Documentation must show the E/M service was significant and separately identifiable

Failure to append modifier 25 can result in claim denial.

CPT 96372 Billing Rules and Payer Considerations

Important payer-specific guidelines include:

• Some payers limit the number of injections billed per day

• Certain medications are bundled into the visit

• Medicare may restrict coverage based on diagnosis

• Medical necessity must be clearly documented

Always verify payer policies before billing CPT 96372.

Common Billing Errors with CPT 96372

At Billing Care Solutions, we frequently identify these issues:

• Billing CPT 96372 without billing the drug

• Incorrect or missing J-codes

• Wrong unit calculations

• Missing modifier 25 when required

• Billing when injection is bundled or non-covered

These mistakes can lead to denials or audits.

CPT 96372 vs CPT 96374

Choosing the correct route of administration is critical.

How Billing Care Solutions Can Help

Billing Care Solutions provides comprehensive billing support, including:

• Injection and medication coding accuracy

• Modifier usage guidance

• Denial management and appeals

• Compliance-focused billing services

• End-to-end revenue cycle management

Our experienced billing team ensures CPT 96372 is billed correctly and reimbursed appropriately.

Final Thoughts

CPT 96372 is a commonly billed injection administration code, but it must be used correctly to avoid denials and compliance risks. Proper documentation, correct medication coding, and payer-specific knowledge are essential.

If your practice is experiencing denials related to CPT 96372, Billing Care Solutions is here to help.

👉 Visit billingcaresolutions.com to learn more about our medical billing and coding services.