Megan Rawson Dec 26, 2022 10:23:39 AM 4 min read

Billing for IV Hydration Therapy

Have you heard of IV Hydration Therapy? This service entails the intravenous administration of electrolyte fluids directly into the bloodstream, allowing fluids to be absorbed and retained in the body without relying on the digestive system. If you are already offering IV Hydration Therapy or are considering providing it to patients in the future, it’s important to understand how exactly it should be billed.

The first consideration when billing IV Hydration Therapy is time, as the total service time must be documented. Therapy lasting from 31 minutes up to the first hour should use code 96360. For therapy lasting longer than an hour, there is an add-on code of 96361 for each additional hour, with a required minimum of 31 minutes into that additional hour. For example:

  • For a total time of 58 minutes, use code 96360 x1.
  • For a total time of 1 hour, 27 minutes, use code 96360 x1.
  • For a total time of 1 hour 42 minutes, use codes 96360 x1, 96361 x1.
  • For a total time of 2 hours 33 minutes, use codes 96360 x1, 96361 x2.

IV Hydration Therapy is not separately billable if total time is less than 31 minutes, is used for the administration of drugs, or when it is done as part of a procedure.

The second thing to remember is that the medical record should support the medical necessity for IV Hydration Therapy in the documentation. This should include the volume, the start and stop times, and the infusion rate. In the absence of a stop time, the provider should be able to calculate the infusion stop time with the volume, start time, and infusion rate. Be sure to check your area LCD and NCD diagnosis code lists to confirm any specific diagnosis codes.

Finally, if a significant, separately identifiable office or outpatient E/M service is performed, the appropriate E/M code should be reported using Modifier 25 in addition to the hydration code(s). For a same-day E/M service, a different diagnosis is not required; however, the time spent for the hydration procedure cannot also be used to support a higher level of E/M service.

Do you still have questions about billing for IV Hydration Therapy? Contact MMG to set up a conversation with our team of experts.