The infusion hierarchy
When a patient receives several services in one encounter, only one is the initial service, and the hierarchy determines which. Choosing the wrong initial service changes payment for the whole visit.
Specialties › Infusion & IV Therapy
Infusion & IV Therapy Billing Services
Infusion billing is decided by rules most practices never see written down: which service is the initial one, which are sequential or concurrent, and how documented start and stop times convert into billable units. Add expensive drugs billed by exact units with wastage reporting, and infusion becomes a specialty where the clinical work is straightforward and the billing is where the money is won or lost.
What makes it hard
Infusion & IV Therapy billing challenges we solve
These are the issues that repeat every month in infusion & iv therapy practices — and the ones we fix at the source rather than reworking claim by claim.
Start and stop times
Infusion units are calculated from documented administration times. Notes without start and stop times cannot support the units billed and are indefensible on audit.
Drug units and wastage
Drugs are billed in defined units that rarely match the vial. Miscalculated units and unreported wastage are among the largest sources of infusion revenue loss.
Medically necessary versus wellness
Hydration and vitamin infusions given for wellness are not covered. Medically necessary hydration is — but only when the diagnosis and documentation support why IV administration was required.
Prior authorization on specialty drugs
High-cost biologics and specialty infusions typically require authorization tied to a specific drug, dose and interval. Any mismatch at administration denies the claim.
Coding depth
Common code families we work with
- 96360 / 96361 — intravenous hydration, initial and each additional hour
- 96365 / 96366 / 96367 / 96368 — therapeutic infusion, initial, additional, sequential, concurrent
- 96374 / 96375 / 96376 — therapeutic IV push
- 96413 / 96415 / 96417 — chemotherapy and complex biologic infusion
- J-code series — drugs billed by defined units
- Modifier JW — drug amount discarded and not administered
- 99202–99215 — separately identifiable evaluation and management
Listed for context only — this is not billing advice, and payer policy varies. Our certified coders work to AAPC and AHIMA standards.
Denial prevention
Top denial drivers in infusion & iv therapy
- Initial service billed incorrectly under the hierarchy
- Start and stop times missing from documentation
- Drug units billed not matching the dose administered
- Hydration considered wellness rather than medically necessary
- Specialty drug given without matching authorization
We root-cause denials by payer and procedure, then fix the upstream workflow so the same denial stops recurring.
Why ERG
What you get with ERG
Specialty-trained billers
Your account is worked by people who bill infusion & iv therapy every day — not a general pool learning your rules on your claims.
95%+ net collection rate
Relentless follow-up on every claim, with aged A/R worked rather than written off.
No long-term contract
Performance-based pricing — a percentage of what we collect. Stay because the results are good, not because you are locked in.
5–10 day onboarding
We run parallel with your current process until the transition is verifiably clean.
Human-led, AI-supported
Our certified coders work every claim; AI tools help them catch more before submission.
HIPAA-compliant throughout
Strict PHI controls, access limits and staff training across the whole workflow.
FAQ
Infusion & IV Therapy billing — common questions
Can insurance be billed for IV hydration?
Sometimes. Wellness and vitamin drips are generally cash-pay, but medically necessary hydration for a documented condition is billable when the record shows why intravenous administration was required. We separate the two so covered care is billed and non-covered care is not sent to the payer in error.
Do you bill infusion centers and specialty biologics?
Yes. We bill infusion suites, rheumatology, GI, neurology and oncology infusion programs, including authorization tracking for high-cost biologics and unit-accurate drug billing.
How do you prevent drug wastage losses?
By billing exact administered units and reporting discarded amounts with the appropriate modifier where payer rules allow. On high-cost drugs this alone frequently pays for our fee.
Do you handle mobile IV and concierge infusion practices?
Yes. We support mobile and concierge models, including a clean split between insurance-billable services and the cash-pay side of the business.
Client results
What practices say about working with us
★★★★★Our A/R days dropped from 58 to 31 in one quarter. First time in years I actually trust my numbers.
— Sarah M., Practice Manager
★★★★★Denials were killing us. First-pass acceptance went up fast, and they tell us why a claim failed — not just rework it quietly.
— Michael R., Billing Lead
Next step
See what your infusion & iv therapy practice is leaving uncollected
A no-obligation A/R analysis. We review your aging, denial patterns and coding mix, then show you exactly where the recoverable revenue is.
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