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These associations hold licenses and/or certifications and are approved to perform in areas of expertise within the bounds of organization:

Articles which directly support an LCD are known as “LCD Reference Articles”. The referenced LCD may be cited in the Article Text field and may also be linked to in the Related Documents field. Examples may include but are not limited to Response to Comments and some Billing and Coding Articles. If you have a question about this kind of article, please contact the MAC listed within the Contractor Information section of the article.

6 = Must be personally performed by a physician or by a physical therapist (PT) who is certified by the American Board of Physical Therapy Specialties (ABPTS) as a qualified electrophysiologic clinical specialist and is permitted to provide the service under state law

Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT for resale and/or license, transferring copies of CDT to any party not bound by this agreement, creating any modified or derivative work of CDT, or making any commercial use of CDT. License to use CDT for any use not authorized herein must be obtained through the American Dental Association, 211 East Chicago Avenue, Chicago, IL 60611. Applications are available at the American Dental Association web site, http://www.ADA.org/ http://www.ADA.org/.

Making copies or utilizing the content of the UB‐04 Manual, including the codes and/or descriptions, for internal purposes, resale and/or to be used in any product or publication; creating any modified or derivative work of the UB‐04 Manual and/or codes and descriptions; and/or making any commercial use of UB‐04 Manual or any portion thereof, including the codes and/or descriptions, is only authorized with an express license from the American Hospital Association. The American Hospital Association (the "AHA") has not reviewed, and is not responsible for, the completeness or accuracy of any information contained in this material, nor was the AHA or any of its affiliates, involved in the preparation of this material, or the analysis of information provided in the material. The views and/or positions presented in the material do not necessarily represent the views of the AHA. CMS and its products and services are not endorsed by the AHA or any of its affiliates.

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Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the article should be assumed to apply equally to all claims.

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5 = Physician supervision does not apply if performed by a qualified audiologist; otherwise general supervision of a physician is required

This article provides information regarding CPT/HCPCS codes that describe diagnostic procedures (and some materials required to perform the diagnostic procedures, i.e., radioactive tracers) that may be performed in an independent diagnostic testing facility (IDTF).

Under Article Text – Table and CPT/HCPCS Codes Group 1: Codes added 0721T, 0722T, 0723T and 0724T. This revision is due to the Q3 CPT®/HCPCS Code Update and is effective 7/1/22.

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In order for an IDTF to be reimbursed by Medicare for any procedure or material included in this article, that specific IDTF must be credentialed and approved by Palmetto GBA provider enrollment to bill for that specific service when provided to a Medicare beneficiary.

4 = Physician supervision does not apply if performed by a qualified independent psychologist or a clinical psychologist; otherwise general supervision of a physician is required

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These materials contain NUBC Official UB-04 Specifications (UB-04 Data), which is copyrighted by the American Hospital Association (AHA).

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21 = Procedure may be performed by a technician with certification under general supervision of a physician; otherwise must be performed under the direct supervision of a physician

Organizations who contract with CMS acknowledge that they may have a commercial CDT license with the ADA, and that use of CDT codes as permitted herein for the administration of CMS programs does not extend to any other programs or services the organization may administer and royalties dues for the use of the CDT codes are governed by their commercial license.

Under Article Text – Table: CPT/HCPCS Codes and CPT/HCPCS Codes Group 1: Codes added 73223. For 73223, under Article Text – Table: Supervising Physician Qualifications added Board Certified* Radiologist or Orthopaedic Surgeon and under Article Text – Table: Technician Qualifications added ARRT: MR or ARMRIT: MRI. Under Article Text – Table: Technician Qualifications for 23350 added General Radiographer, for 76380 added General Radiographer, Medical Physicist or ARRT: R.T.-R and ARRT: R.T.-CT and removed ARDMS: RDMS-NE or ARRT: R.T.-S, for 19083 and 19084 added ARRT: R.T.-R, for 76706 added ARDMS: RVT, ARRT R.T.-S, R.T.-VS or CCI: RVS and removed ARRT: R.T.-BS, for 93017 added NHA: CET, ARRT: R.T.-N or NMTCB: CNMT.

Under Article Text – Table: CPT/HCPCS Codes and CPT/HCPCS Codes Group 1: Codes deleted 0501T, 0502T, 0503T, 0504T and 74710. Under CPT/HCPCS Codes Group 1: Codes the description was revised for 19000, 19001, 19030, 92060, 92081, 92082, 92083, 92235, 92240, 92242, 92250, 92260, 92265, 92270, 92283, 92285, 92286 and 99202. This revision is due to the 2024 Annual/Q1 CPT/HCPCS Code Update and is retroactive effective for dates of service on or after 1/1/24.

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CMS Internet-Only Manual, Pub. 100-02, Medicare Benefit Policy Manual, Chapter 15, §80.2 Psychological and Neuropsychological Tests and §80.6 Requirements for Ordering and Following Orders for Diagnostic Tests

The listing of a procedure code does not guarantee that Medicare will reimburse the service. All services are subject to Medicare medical necessity and coverage policies, including National Coverage Decisions, Local Coverage Decisions, statutory exclusions and instructions in interpretive manuals.

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Subject to the terms and conditions contained in this Agreement, you, your employees and agents are authorized to use CDT only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. Use of CDT is limited to use in programs administered by Centers for Medicare & Medicaid Services (CMS). You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. You acknowledge that the ADA holds all copyright, trademark and other rights in CDT. You shall not remove, alter, or obscure any ADA copyright notices or other proprietary rights notices included in the materials.

Codes 0648T, 0650T, 0651T, 0652T, 0658T and 0659T were added to the Article Text - Table and CPT/HCPCS Codes Group 1: Codes sections of this article. This revision is due to the QTR3 2021 CPT/HCPCS code update and has a retroactive effective date of 7/1/21.

This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, AMA Plaza, 330 N. Wabash Ave., Suite 39300, Chicago, IL 60611-5885. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of FAR 52.227-14 (December 2007) and/or subject to the restricted rights provisions of FAR 52.227-14 (December 2007) and FAR 52.227-19 (December 2007), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements.

If you are acting on behalf of an organization, you represent that you are authorized to act on behalf of such organization and that your acceptance of the terms of this agreement creates a legally enforceable obligation of the organization. As used herein, "you" and "your" refer to you and any organization on behalf of which you are acting.

Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

Some articles contain a large number of codes. If you are looking for a specific code, use your browser's Find function (Ctrl-F) to quickly locate the code in the article. Sometimes, a large group can make scrolling thru a document unwieldy. You can collapse such groups by clicking on the group header to make navigation easier. However, please note that once a group is collapsed, the browser Find function will not find codes in that group.

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes.

Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized herein must be obtained through the AMA, CPT Intellectual Property Services, AMA Plaza, 330 Wabash Ave., Suite 39300, Chicago, IL 60611-5885. Applications are available at the AMA Web site, http://www.ama-assn.org/go/cpt http://www.ama-assn.org/go/cpt.

Articles are a type of document published by the Medicare Administrative Contractors (MACs). Articles often contain coding or other guidelines and may or may not be in support of a Local Coverage Determination (LCD).

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You, your employees, and agents are authorized to use CPT only as agreed upon with the AMA internally within your organization within the United States for the sole use by yourself, employees, and agents. Use is limited to use in Medicare, Medicaid or other programs administered by the Centers for Medicare and Medicaid Services (CMS). You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement.

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With these updates certain codes may be deleted but will still be appropriate for billing up to 1 year after the procedure date. A listing of these codes that may still be valid are located in the Other Coding Information section of this article.

Articles are often related to an LCD, and the relationship can be seen in the “Associated Documents” section of the Article or the LCD. Article document IDs begin with the letter “A” (e.g., A12345). Draft articles have document IDs that begin with “DA” (e.g., DA12345).

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This page displays your requested Article. The document is broken into multiple sections. You can use the Contents side panel to help navigate the various sections. Articles are a type of document published by the Medicare Administrative Contractors (MACs). Articles often contain coding or other guidelines and may or may not be in support of a Local Coverage Determination (LCD).

Articles identified as “Not an LCD Reference Article” are articles that do not directly support a Local Coverage Determination (LCD). They do not include a citation of an LCD. An example would include, but is not limited to, the Self-Administered Drug (SAD) Exclusion List Articles. If you have a question about this kind of article, please contact the MAC listed within the Contractor Information section of the article.

Under Article Text – Table: Technician Qualifications added ARDMS: RDCS to the following CPT/HCPCS codes 93005, 93224, 93225, 93226, 93241, 93242, 93243, 93244, 93245, 93246, 93247 and 93248.

6A = Supervision standards for level 66 apply; in addition, the PT with ABPTS certification may supervise another PT, but only the PT with ABPTS certification may bill

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2) Try using the MCD Search and enter your information in the "Enter keyword, code, or document ID" box. Your information could include a keyword or topic you're interested in; a Local Coverage Determination (LCD) policy or Article ID; or a CPT/HCPCS procedure/billing code or an ICD-10-CM diagnosis code. Try entering any of this type of information provided in your denial letter.

66 = May be performed by a physician or a physical therapist with ABPTS certification and certification in this specific procedure

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ADA DISCLAIMER OF WARRANTIES AND LIABILITIES CDT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. No fee schedules, basic unit, relative values, or related listings are included in CDT. The ADA does not directly or indirectly practice medicine or dispense dental services. The sole responsibility for software, including any CDT and other content contained therein, is with (insert name of applicable entity) or the CMS; and no endorsement by the ADA is intended or implied. The ADA expressly disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This Agreement will terminate upon notice to you if you violate the terms of this Agreement. The ADA is a third-party beneficiary to this Agreement.

If you need more information on coverage, contact the Medicare Administrative Contractor (MAC) who published the document. The contractor information can be found at the top of the document in the Contractor Information section (expand the section to see the details).

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These materials contain Current Dental Terminology (CDTTM), copyright© 2023 American Dental Association (ADA). All rights reserved. CDT is a trademark of the ADA.

CMS Internet-Only Manual, Pub. 100-04, Medicare Claims Processing Manual, Chapter 35, Independent Diagnostic Testing Facility (IDTF)

End User Point and Click Agreement: CPT codes, descriptions and other data only are copyright 2023 American Medical Association. All Rights Reserved (or such other date of publication of CPT). CPT is a trademark of the American Medical Association (AMA).

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Under Article Text – Table: CPT/HCPCS Codes and CPT/HCPCS Codes Group 1: Codes added 75580. For 75580, under Article Text – Table: Supervising Physician Qualifications added Board Certified* Cardiologist or Radiologist and under Article Text – Table: Technician Qualifications added General Radiographer, Medical Physicist or ARRT: R.T.-R and ARRT: R.T.-CT. This revision is retroactive effective for dates of service on or after 1/1/24.

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Enter the CPT/HCPCS code in the MCD Search and select your state from the drop down. (You may have to accept the AMA License Agreement.) Look for a Billing and Coding Article in the results and open it. (Or, for DME MACs only, look for an LCD.) Review the article, in particular the Coding Information section.

Title XVIII of the Social Security Act, §1833(e) prohibits Medicare payment for any claim lacking the necessary documentation to process the claim.

Under Article Text – Table and CPT/HCPCS Codes Group 1: Codes added codes 42975, 91113, 93319, 0689T, 0690T, 0691T, 0693T, 0697T, and 0698T, and deleted codes 72275, 76101, 76102, 92561, 92564 and 95943. The descriptions were revised for codes 0598T, 0648T, 75573 and 99211. This revision is due to the Annual CPT/HCPCS code update and has an effective date of 1/1/22.

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77 = Procedure must be performed by a PT with ABPTS certification (TC & PC) or by a PT without certification under direct supervision of a physician (TC & PC), or by a technician with certification under general supervision of a physician (TC only; PC always physician)

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CMS Internet-Only Manual, Pub. 100-04, Medicare Claims Processing Manual, Chapter 1, §30.2 Assignment of Provider’s Right to Payment

Additional services/items (e.g., radiopharmaceutical agents, special contrast agents, medications, etc.) are considered supplies and are also payable to an IDTF if they are commonly separately reimbursed to a physician in a physician’s office setting. They are not listed in this article, in that if the test is payable, the supplies will be also.

CMS DISCLAIMER The scope of this license is determined by the ADA, the copyright holder. Any questions pertaining to the license or use of the CDT should be addressed to the ADA. End Users do not act for or on behalf of the CMS. CMS disclaims responsibility for any liability attributable to end user use of the CDT. CMS will not be liable for any claims attributable to any errors, omissions, or other inaccuracies in the information or material covered by this license. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material.

For the most part, codes are no longer included in the LCD (policy). You will find them in the Billing & Coding Articles. Try using the MCD Search to find what you're looking for. Enter the code you're looking for in the "Enter keyword, code, or document ID" box. The list of results will include documents which contain the code you entered.

7A = Must be personally performed by a physical therapist (PT) who is certified by the American Board of Physical Therapy Specialties (ABPTS) or by a PT without certification under direct supervision of a physician, or by a technician with certification under general supervision; in addition, the PT with ABPTS certification may supervise another PT, but only the PT with ABPTS certification may bill

Under Article Text revised the heading below the table to read “These associations hold licenses and/or certifications and are approved to perform in areas of expertise within the bounds of organization”, and added the National Healthcare Association (NHA) as an approved organization for EKG Technicians.

CPT codes, descriptions, and other data only are copyright 2023 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

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NCDs do not contain claims processing information like diagnosis or procedure codes nor do they give instructions to the provider on how to bill Medicare for the service or item. For this supplementary claims processing information we rely on other CMS publications, namely Change Requests (CR) Transmittals and inclusions in the Medicare Fee-For-Service Claims Processing Manual (CPM).

Under Article Text – Table and CPT/HCPCS Codes Group 1: Codes added 78492 and 78609. This revision is also effective 7/1/22.

The information in this article may not be all-inclusive and may be subject to change as CPT/HCPCS codes are updated. The codes included in this article are based on the latest coding updates. The effective date of this article is the date of the most recent update.

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The scope of this license is determined by the AMA, the copyright holder. Any questions pertaining to the license or use of the CPT should be addressed to the AMA. End Users do not act for or on behalf of the CMS. CMS disclaims responsibility for any liability attributable to end user use of the CPT. CMS will not be liable for any claims attributable to any errors, omissions, or other inaccuracies in the information or material contained on this page. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material.

Please Note: For Durable Medical Equipment (DME) MACs only, CPT/HCPCS codes remain located in LCDs. All other Codes (ICD-10, Bill Type, and Revenue) have moved to Articles for DME MACs, as they have for the other Local Coverage MAC types.

In order for CMS to change billing and claims processing systems to accommodate the coverage conditions within the NCD, we instruct contractors and system maintainers to modify the claims processing systems at the national or local level through CR Transmittals. CRs are not policy, rather CRs are used to relay instructions regarding the edits of the various claims processing systems in very descriptive, technical language usually employing the codes or code combinations likely to be encountered with claims subject to the policy in question. As clinical or administrative codes change or system or policy requirements dictate, CR instructions are updated to ensure the systems are applying the most appropriate claims processing instructions applicable to the policy.

It is not appropriate to bill Medicare for services that are not covered as if they are covered. When billing for non-covered services, use the appropriate modifier.

Articles which directly support an LCD are known as “LCD Reference Articles”. The referenced LCD may be cited in the Article Text field and may also be linked to in the Related Documents field. Examples may include but are not limited to Response to Comments and some Billing and Coding Articles. If you have a question about this kind of article, please contact the MAC listed within the Contractor Information section of the article. Articles identified as “Not an LCD Reference Article” are articles that do not directly support a Local Coverage Determination (LCD). They do not include a citation of an LCD. An example would include, but is not limited to, the Self-Administered Drug (SAD) Exclusion List Articles. If you have a question about this kind of article, please contact the MAC listed within the Contractor Information section of the article. There are different article types: Billing and Coding articles provide guidance for the related Local Coverage Determination (LCD) and assist providers in submitting correct claims for payment. Billing and Coding articles typically include CPT/HCPCS procedure codes, ICD-10-CM diagnosis codes, as well as Bill Type, Revenue, and CPT/HCPCS Modifier codes. The code lists in the article help explain which services (procedures) the related LCD applies to, the diagnosis codes for which the service is covered, or for which the service is not considered reasonable and necessary and therefore not covered. Response to Comment (RTC) articles list issues raised by external stakeholders during the Proposed LCD comment period. Self-Administered Drug (SAD) Exclusion List articles list the CPT/HCPCS codes that are excluded from coverage under this category. The Medicare program provides limited benefits for outpatient prescription drugs. The program covers drugs that are furnished "incident-to" a physician's service provided that the drugs are not "usually self-administered" by the patient. CMS has defined "not usually self-administered" according to how the Medicare population as a whole uses the drug, not how an individual patient or physician may choose to use a particular drug. For purpose of this exclusion, "the term 'usually' means more than 50 percent of the time for all Medicare beneficiaries who use the drug. Therefore, if a drug is self-administered by more than 50 percent of Medicare beneficiaries, the drug is excluded from coverage" and the MAC will make no payment for the drug. Draft articles are articles written in support of a Proposed LCD. A Draft article will eventually be replaced by a Billing and Coding article once the Proposed LCD is released to a final LCD.

Applicable Federal Acquisition Regulation Clauses (FARS)/Department of Defense Federal Acquisition Regulation supplement (DFARS) Restrictions Apply to Government Use.

Under CPT/HCPCS Codes Group 1: Codes the description was revised for 0723T, 0724T, 24220, 76882, 78803, 78830, 78831, 78832, 92229 and 92284. This revision is due to the 2023 Annual/Q1 CPT/HCPCS Code Update and is retroactive effective for dates of service on or after 1/1/23.

The following list defines the numeric level of physician supervision for diagnostic procedures assigned to each CPT/HCPCS code and is located in the Medicare Physician Fee Schedule Database (MPFSDB).