When should I use 96372?

SC or IM injection of a therapeutic drug (e.g. ketorolac, vitamin B12, depot antipsychotic, biologic).

What documentation does 96372 require?

- Drug name, dose, route, site. - Indication. - Supervision (if patient self-injecting under observation).

What are common 96372 billing pitfalls?

- Cannot bill 96372 for vaccines — use 90471/90472. - Drug code (J-code) is billed separately.

How much does 96372 pay in 2026?

2026 work RVU for 96372 is 0.17. National Medicare non-facility allowable is approximately $15.36 at the 2026 conversion factor. Adjust for locality GPCI and your payer's contracted conversion factor for actual payment.

Procedures · CMS status A

96372

Ther/proph/diag inj sc/im

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

Outpatient IM Allergy Rheum

Model in calculator →Audit a note

Work RVU

0.17

2026 Medicare pays

$15.36

National GPCI · non-facility · CF $33.4009

RVU anatomyWork 0.17 + Practice 0.28 + Malpractice 0.01 = 0.46 total

Work (your effort)Practice expenseMalpractice

When to use it

SC or IM injection of a therapeutic drug (e.g.

Full guidance

ketorolac, vitamin B12, depot antipsychotic, biologic).

Documentation checklist

✓Drug name, dose, route, site.
✓Indication.
✓Supervision (if patient self-injecting under observation).

Common pitfalls

!Cannot bill 96372 for vaccines — use 90471/90472.
!Drug code (J-code) is billed separately.

Common modifiers

Common ICD-10 pairings

M79.1D51.0

Pairs well with

99213

1.30 wRVU

Office o/p est low 20 min

99214

1.92 wRVU

Office o/p est mod 30 min

Educational reference, not billing or legal advice. Verify against your payer contracts and your compliance team before submission.