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LCD Reference Article Billing and Coding Article

Billing and Coding: Independent Diagnostic Testing Facility (IDTF)

A53252

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Draft Articles are works in progress and not necessarily a reflection of the current billing and coding practices. Revisions to codes are carefully and thoroughly reviewed and are not intended to change the original intent of the LCD.

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General Information

Source Article ID
N/A
Article ID
A53252
Original ICD-9 Article ID
Not Applicable
Article Title
Billing and Coding: Independent Diagnostic Testing Facility (IDTF)
Article Type
Billing and Coding
Original Effective Date
10/01/2015
Revision Effective Date
04/01/2024
Revision Ending Date
N/A
Retirement Date
N/A
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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.

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CMS National Coverage Policy

Internet-Only Manuals (IOMs)

  • CMS IOM Publication 100-02, Medicare Benefit Policy Manual,
    • Chapter 15, Section 60, Services and Supplies Furnished Incident to a Physician/NPP professional service, Section 80, Requirements for Diagnostic Xray, Diagnostic Laboratory, and Other Diagnostic Tests
  • CMS IOM Publication 100-04, Medicare Claims Processing Manual,
    • Chapter 1, Section 10.1.1 Payment Jurisdictions Among A/B MACS (B) for Services Paid Under the Physician Fee Schedule and Anesthesia Services, Section 30.2 Assignment of Provider’s Right to Payment
    • Chapter 35, Independent Diagnostic Testing Facility (IDTF)
  • CMS IOM Publication 100-08, Medicare Program Integrity Manual,
    • Chapter 3, Section 3.2.3.3 Third-Party Additional Documentation Request
    • Chapter 10, Section 10.2.2.4 Independent Diagnostic Testing Facilities (IDTFs)

Social Security Act (Title XVIII) Standard References:

  • Title XVIII of the Social Security Act, Section 1833(e) states that no payment shall be made to any provider of services or other person under this part unless there has been furnished such information as may be necessary in order to determine the amounts due such provider or other person under this part for the period with respect to which the amounts are being paid or for any prior period.

Code of Federal Regulations (CFR) References:

  • CFR, Title 42, Chapter IV, Part 410 §410.32(a) Ordering diagnostic tests
  • CFR, Title 42, Chapter IV, Part 410 §410.33 Independent diagnostic testing facility

Article Guidance

Article Text

This Billing and Coding Article provides billing and coding guidance for Independent Diagnostic Testing Facilities (IDTFs). Diagnostic testing performed in an IDTF must follow the supervision and credentialing guidelines set forth in this Local Coverage Article. All enrolling IDTFs must meet the supervising physician qualification/proficiency requirements and technician qualification requirements at the time of their enrollment.

Coding Guidance

IDTFs are required to report the exact CPT/HCPCS codes/procedures they intend to perform when enrolling with the CMS-855B form. If an IDTF which is already enrolled wants to perform additional CPT or HCPCS code tests that were not originally specified on its CMS-855B and that are for procedure types and supervision levels similar to its previously allowed codes, the contractor shall have the IDTF amend its CMS-855B to add the additional codes and equipment listing. A new site visit is not required. However, if the enrolled IDTF will be performing CPT or HCPCS codes for different types of procedures, or with different supervision levels, a new site visit is required. Claims submitted with procedure codes not reported on the CMS-855B form and reviewed by the contractor will be denied.

Each IDTF will have a specific and unique list of CPT/HCPCS codes for which it can be paid by the contractor, and it is the responsibility of the IDTF to obtain specific contractor approval to bill each CPT/HCPCS code that it intends to bill. Based on equipment and personnel requirements, IDTFs are required to submit a list of all procedure codes performed by the facility to Medicare Provider Enrollment. The codes and equipment should be listed on Attachment 2, Section 1 of Enrollment Application Form CMS-855B.

Desk and Site Reviews

All new IDTF applications shall receive a thorough desk review, and a mandatory site review prior to the contractor's enrollment of the applicant and issuance of a billing number. The general purpose of both reviews is to determine whether the information listed on Attachment 2 of the CMS-855B is correct, verifiable, and in accordance with IDTF regulatory and manual requirements.

Site Visits for Mobile Units and Electronic Monitoring Services

Mobile units are required to list their geographic service area. They can be site visited by the following methods:

  • The mobile unit may visit the office of the site reviewer, OR
  • The site reviewer can obtain an advance schedule of the locations the IDTF will be visiting and conduct the site visit at one of those locations.

Transtelephonic and electronic monitoring services (e.g., 24-hour ambulatory EKG monitoring; pacemaker monitoring and cardiac event detection) should be classified as IDTFs and must meet all IDTF requirements. These entities require a supervisory physician who performs general supervision. Final enrollment of a transtelephonic or electronic monitoring service, such as an IDTF, requires a site visit.

Additional information may be found in CMS Internet-Only Manual (IOM) Publication 100-04, Medicare Claims Processing Manual, Chapter 35, Independent Diagnostic Testing Facility (IDTF).

Supervising Physicians

An IDTF must have one or more supervising physicians who are responsible for the direct and ongoing oversight of the quality of the testing performed, the proper operation and calibration of the equipment used to perform tests, and the qualifications of non-physician personnel who use the equipment.

Not every supervising physician has to be responsible for all these functions. These responsibilities may be divided among the supervising physicians. For example, one supervising physician may be responsible only for the operation and calibration of the equipment, while other supervising physicians responsible for test supervision and/or the qualifications of the non-physician personnel.

Additional information may be found in the CMS IOM Publication 100-02, Chapter 15, Section 80 and 42 CFR §410.32(b) and §410.33.

Non-Physician Personnel

The contractor does not establish a credentialing service, but the contractor is authorized to determine which organizations it recognizes. For example, the use of the word “national” in the organization’s name does not, in itself, meet Medicare standards for national credentialing.

The supervising physician and non-physician personnel credentialing requirements are listed below in the Credentialing Matrix.

Additional information may be found in the CMS IOM Publication100-02, Chapter 15, Sections 80.2, 80.3, and 190 as well as 42 CFR §410.33.

Interpreting Physicians

An IDTF is not restricted to billing only the technical component of diagnostic services. In certain situations, an IDTF can bill for both the technical component of the diagnostic test and interpretative services. This approach is referred to as billing "globally". The interpretative services must be performed by a licensed practitioner who is allowed to perform the service.

When enrolling or updating information, the IDTF shall list all physicians for whose diagnostic test interpretations it will bill. This includes physicians who are providing purchased interpretations to the IDTF (in accordance with CMS Manual System, Pub. 100-04, Medicare Claims Processing Manual, Chapter 1, Section 30.2), as well as physicians who are reassigning their benefits to the IDTF. The contractor will ensure and document the following:

  • All physicians listed are enrolled in Medicare.
  • All interpreting physicians who are reassigning their benefits to the IDTF have the right to do so.
  • All required CMS-855R forms have been submitted.
  • The interpreting physicians listed are qualified to interpret the types of tests (codes) listed. In accordance with this CMS requirement (CMS Manual System, Pub. 100-08, Medicare Program Integrity Manual, Chapter 15, Section 15.5.19.3).

Note: The applicant cannot bill globally for interpreting physicians not listed.

If an interpreting physician has been recently added or changed, the new interpreting physician must have met all of the interpreting physician requirements at the time any tests were performed.

Off-Site Interpretations

If an IDTF wants to bill for an interpretation performed by an independent practitioner off the premises of the IDTF, it must meet all instructions identified in the CMS Manual System, Pub. 100-04, Medicare Claims Processing Manual, Chapter 1, concerning purchased interpretations. In this scenario, there is no reassignment of benefits because the purchaser of the test is also considered the supplier of the test.

When the technical component of a test is performed by the IDTF and the interpreting practitioner is the practitioner who ordered the test, the IDTF cannot bill for the interpretation. The interpreting practitioner must bill the interpretation since the IDTF cannot bill the interpretation when the interpreting physician is the referring physician.

Purchased Diagnostic Tests and Jurisdictional Pricing

Services that are reimbursed under the Medicare Physician Fee Schedule (MPFS) are reimbursed by the payment locality where the service is furnished and by the zip code. Contractors must use the zip code of the location where the service was rendered to determine contractor jurisdiction over the claim and the correct payment locality.

When a physician, practitioner, or supplier furnishes services in payment localities that cover more than one contractor's service area (e.g., the provider has separate offices in multiple localities and/or multiple contractors), separate claims must be submitted to the appropriate contractor for processing.

Providers may not submit a global billing code on paper or electronic claims when one component of the service has been purchased. Only one service facility location (name, address and zip code) can be indicated in item 32 on the CMS-1500 form. Claims received with global services will be returned as unprocessable.

Suppliers (including laboratories, physicians, and IDTFs) must bill their local contractor for all purchased diagnostic tests/interpretations, regardless of the location where the purchased service was rendered.

Purchased Technical Components

A physician may bill for the technical component of a diagnostic test that he/she purchased from another physician, medical group or supplier. However, in order to purchase a diagnostic test from another physician, medical group, or supplier, the purchaser must perform the interpretation (professional component). Additionally, the physician or supplier that furnished the technical component must be enrolled in the Medicare program.

Purchased Interpretations

A person or entity that provides diagnostic tests may submit the claim and, if assignment is accepted, receive the Part B payment, for diagnostic test interpretations which that person or entity purchases from an independent physician or medical group if:

  • The tests are initiated by a physician or medical group which is independent of the person or entity providing the tests and of the physician or medical group providing the interpretations;
  • The physician or medical group providing the interpretations does not see the patient;
  • The purchaser (or employee, partner, or owner of the purchaser) performs the technical component of the test. The interpreting physician must be enrolled in the Medicare program. No formal reassignment is necessary; AND
  • The purchaser must keep on file the name, the provider identification number and address of the interpreting physician.

Note: This does not remove the requirement that when an entity either purchases an interpretation or a test, they must perform the other component in order to be paid for the purchased component.

In order to price claims correctly and apply purchase price limitations, global billing is not acceptable for claims received on the Form CMS-1500 or on the ANSI X12N 837 electronic format. Each component must be billed as a separate line item (or on a separate claim).

Suppliers (including laboratories, physicians, and IDTFs) must submit claims for all purchased diagnostic tests/interpretations to their local contractor, regardless of the location where the purchased service was furnished.

Additional Services/Supplies

Additional services/items (e.g., radiopharmaceutical agents, special contrast agents, medications, etc.) related to, or generally considered required for, performing a diagnostic test are also payable to an IDTF if they are commonly separately reimbursed to a physician in a physician’s office setting.

An IDTF can bill these practitioner services when they are performed by a qualified practitioner in accordance with coverage, payment, and general billing rules, and in accordance with the reassignment of benefit and purchased test rules.

These additional services/items which are necessary for the performance of specific diagnostic tests may be billed by an IDTF if approval is granted by the contractor for the IDTF to bill for the specific test(s) that require such items/services. For example, some procedures require an injection of a joint for arthrography and would be allowed if the procedure is integral to the diagnostic test the IDTF is permitted to perform.

However, an IDTF is not allowed to bill for surgical procedures that are clearly not related to or required for a diagnostic test.

At the time that the IDTF requests contractor approval to perform the tests, the IDTF must identify all such items/services that it intends to bill in conjunction with specific tests.

JW and JZ Modifiers

When billing for Part B drugs and biologicals (except those provided under a competitive acquisition program [CAP]), the use of the JW modifier to identify unused drugs or biologicals from single use vials or single use packages that are appropriately discarded is required. The discarded amount shall be billed on a separate claim line using the JW modifier. Providers are required to document the discarded drug or biological in the patient’s medical record.

Any amount wasted must be clearly documented in the medical record and should include the date and time, amount of medication wasted, and the reason for the wastage.

The use of the JZ modifier (attesting that there were no discarded amounts) is required on claims to report there are no discarded amounts of unused drugs or biologicals from single use vials or single use packages.

Claims for drugs separately payable under Medicare Part B from single-dose containers are required to report either the JW or JZ modifier, to identify any discarded amounts or to attest that there are no discarded amounts, respectively.

  • The JW and JZ modifier policy does not apply for drugs that are not separately payable, such as packaged OPPS or ASC drugs, or drugs administered in the FQHC or RHC setting.

The JW and JZ modifiers do not apply to drugs assigned status indicator N (Items and Services Packaged into APC Rates) under the OPPS. Similarly, the JW and JZ modifiers do not apply to drugs assigned payment indicator “N1” (ASC).

Documentation Requirements

  1. All documentation must be maintained in the patient's medical record and made available to the contractor upon request.
  2. Every page of the record must be legible and include appropriate patient identification information (e.g., complete name, dates of service[s]). The documentation must include the legible signature of the physician or non-physician practitioner responsible for and providing the care to the patient.
  3. The submitted medical record must support the use of the selected ICD-10-CM code(s). The submitted CPT/HCPCS code must describe the service performed.
  4. Medical record documentation maintained by the IDTF must include the information listed below and be available upon request:
    1. Written order from the treating physician, and
    2. Hard copy documentation of the test results and interpretation.
  1. The IDTF must maintain documentation to demonstrate the required physician supervision requirements were met. Also, the IDTF must maintain documentation of sufficient physician resources during all hours of operation to assure that the required physician supervision is furnished.
  2. Multi-state entities must maintain evidence that supervising physicians are licensed to practice in the state(s) where the diagnostic tests are performed and the technicians performing the diagnostic test(s) are credentialed appropriately in each state in which services are performed in accordance with requirements outlined in this article.
  3. Documentation maintained by the IDTF must support that the personnel performing the diagnostic test(s) have the training and proficiency as evidenced by current licensure or certification as outlined in this article. This documentation must contain verification by the supervising physician(s).

Physician Supervision of Diagnostic Procedures

Supervision Level

Description

01

Procedure must be performed under the general supervision of a physician.

02

Procedure must be performed under the direct supervision of a physician.

03

Procedure must be performed under the personal supervision of a physician.

04

Physician supervision policy does not apply when procedure is furnished by a qualified, independent psychologist or a clinical psychologist. Otherwise the procedure must be performed under the general supervision of a physician.

05

Physician supervision policy does not apply when procedure is furnished by a qualified audiologist; otherwise must be performed under the general supervision of a physician.

06

Procedure must be personally performed by a physician or a Physical Therapist (PT) who is certified by the American Board of Physical Therapy Specialties (ABPTS) as a qualified electrophysiological clinical specialist and is permitted to provide the procedure under State law. Procedure may also be performed by a PT with ABPTS certification without physician supervision.

21

Procedure may be performed by a technician with certification under general supervision of a physician. Otherwise the procedure must be performed under direct supervision of a physician. Procedure may also be performed by a PT with ABPTS certification without physician supervision.

22

May be performed by a technician with on-line real-time contact with a physician.

66

May be personally performed by a physician or by a PT with ABPTS certification and certification in this specific procedure.

6A

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

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).

7A

Supervision standards for level 77 apply; in addition, the PT with ABPTS certification may personally supervise another PT, but only the PT with ABPTS certification may bill.

09

Concept does not apply.

The provider is responsible for adhering to applicable CMS regulations for diagnostic test supervision.

Credentialing Matrix

The following table reflects CMS supervision requirements, which describes the levels of physician supervision required for furnishing the technical component of diagnostic tests for Medicare beneficiaries who are not a hospital inpatient or outpatient.

*American Board of Medical Specialty (ABMS), American Board of Nuclear Medicine (ABNM), American Board of Physical Medicine and Rehabilitation (ABPMR), American Board of Psychiatry and Neurology (ABPN), American Osteopathic Association (AOA), or subspecialty certification.

CPT/HCPCS CODES

LEVEL OF PHYSICIAN SUPERVISION

SUPERVISING PHYSICIAN QUALIFICATION REQUIREMENTS

TECHNICIAN QUALIFICATION REQUIREMENTS

10005

09

Board Certified* Radiologist

Credentialed by ARRT in ultrasound

10006

09

Board Certified* Radiologist

Credentialed by ARRT in ultrasound

10007

09

Board Certified* Radiologist

Credentialed by ARRT in fluoroscopy

10008

09

Board Certified* Radiologist

Credentialed by ARRT in fluoroscopy

10009

09

Board Certified* Radiologist

Credentialed by ARRT in CT

10010

09

Board Certified* Radiologist

Credentialed by ARRT in CT

10011

09

Board Certified* Radiologist

Credentialed by ARRT in MRI

10012

09

Board Certified* Radiologist

Credentialed by ARRT in MRI

10021

09

Board Certified* Physician

N/A

19000

09

Board Certified* Radiologist or Surgeon

General Radiographer or Credentialed by ARRT: R.T.-R or ARRT: R.T.-M or ARDMS: RDMS or RT BS or ARRT: MR or ARMRIT: MRI

19001

09

Board Certified* Radiologist or Surgeon

General Radiographer or Credentialed by ARRT: R.T.-R or ARRT: R.T.-M or ARDMS: RDMS or RT BS or ARRT: MR or ARMRIT: MRI

19081

09

Board Certified* Radiologist or Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R or ARRT: R.T.-M or ARDMS: RDMS or RT BS or ARRT: MR or ARMRIT: MRI

 

19082

09

Board Certified* Radiologist or Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R or ARRT: R.T.-M or ARDMS: RDMS or RT BS or ARRT: MR or ARMRIT: MRI

19083

09

Board Certified* Radiologist or Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R or ARRT: R.T.-M or ARDMS: RDMS or RT BS or ARRT: MR or ARMRIT: MRI

19084

09

Board Certified* Radiologist or Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R or ARRT: R.T.-M or ARDMS: RDMS or RT BS or ARRT: MR or ARMRIT: MRI

19085

09

Board Certified* Radiologist or Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R or ARRT: R.T.-M or ARDMS: RDMS or RT BS or ARRT: MR or ARMRIT: MRI

 

19086

09

Board Certified* Radiologist or Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R or ARRT: R.T.-M or ARDMS: RDMS or RT BS or ARRT: MR or ARMRIT: MRI

19281

09

Board Certified* Radiologist or Surgeon

General Radiographer or Credentialed by ARRT: R.T.-R or ARRT: R.T.-M or ARDMS: RDMS or RT BS or ARRT: MR or ARMRIT: MRI

19283

09

Board Certified* Radiologist or Surgeon

General Radiographer or Credentialed by ARRT: R.T.-R or ARRT: R.T.-M or ARDMS: RDMS or RT BS or ARRT: MR or ARMRIT: MRI

19285

09

Board Certified* Radiologist or Surgeon

General Radiographer or Credentialed by ARRT: R.T.-R or ARRT: R.T.-M or ARDMS: RDMS or RT BS or ARRT: MR or ARMRIT: MRI

20501

09

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

23350

09

Board Certified* Radiologist or Orthopedist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

24220

09

Board Certified* Radiologist or Orthopedist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

25246

09

Board Certified* Radiologist or Orthopedist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

27369

09

Board Certified* Radiologist or Orthopedist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R or ARRT: R.T.-CT or R.T.- MR or ARMRIT: MRI

27648

09

Board Certified* Radiologist, Orthopedist or Podiatrist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

27093

09

Board Certified* Radiologist or Orthopedist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

27095

09

Board Certified* Radiologist or Orthopedist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

36901

09

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

42550

09

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

43754

09

Board Certified* Gastroenterologist

RN

43755

09

Board Certified* Gastroenterologist

RN

47531

09

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

47532

09

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

47544

09

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

51600

09

Board Certified* Radiologist or Urologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

51610

09

Board Certified* Radiologist or Urologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

51725

02

Board Certified* Urologist

Urology or OB/GYN Personally Trained Staff

51726

02

Board Certified* Urologist

Urology or OB/GYN Personally Trained Staff

51727

02

Board Certified* Urologist

Urology or OB/GYN Personally Trained Staff

51728

02

Board Certified* Urologist

Urology or OB/GYN Personally Trained Staff

51729

02

Board Certified* Urologist

Urology or OB/GYN Personally Trained Staff

51736

02

Board Certified* Urologist

Urology or OB/GYN Personally Trained Staff

51741

02

Board Certified* Urologist

Urology or OB/GYN Personally Trained Staff

51784

02

Board Certified* Urologist, Neurologist or Physiatrist

Urology or OB/GYN Personally Trained Staff

51785

03

Board Certified* Urologist, Neurologist or Physiatrist

Urology or OB/GYN Personally Trained Staff

51792

02

Board Certified* Urologist, Neurologist or Physiatrist

Urology or OB/GYN Personally Trained Staff

51797

02

Board Certified* Urologist

Urology or OB/GYN Personally Trained Staff

51798

09

Board Certified* Urologist or Radiologist

Urology or OB/GYN Personally Trained Staff or State License: General Radiographer or Credentialed by ARRT: R.T.-R

54240

02

Board Certified* Urologist

Credentialed by ARDMS: RVT or CCI: RVS

54250

01

Board Certified* Urologist

Credentialed by ARDMS: RVT or CCI: RVS

58340

09

Board Certified* Radiologist or Gynecologist

Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S

59025

01

Board Certified* Obstetrics/Gynecology

RN

62284

09

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

62302

09

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

62303

09

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

62304

09

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

62305

09

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

70010

09

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

70015

03

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

70030

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

70100

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

70110

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

70120

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

70130

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

70134

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

70140

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

70150

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

70160

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

70170

03

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

70190

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

70200

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

70210

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

70220

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

70240

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

70250

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

70260

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

70300

01

Board Certified* Radiologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

70310

01

Board Certified* Radiologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

70320

01

Board Certified* Radiologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

70328

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

70330

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

70332

03

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Credentialed by ARRT: R.T.-R

70336

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: MR or ARMRIT: MRI

70350

01

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

70355

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Credentialed by ARRT: R.T.-R

70360

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

70370

03

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

70371

03

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

70380

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

70390

03

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Credentialed by ARRT: R.T.-R

70450

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

70460

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

70470

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

70480

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

70481

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

70482

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

70486

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

70487

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

70488

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

70490

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

70491

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

70492

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

70496

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

70498

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

70540

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: MR or ARMRIT: MRI

70542

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: MR or ARMRIT: MRI

70543

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: MR or ARMRIT: MRI

70544

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: MR or ARMRIT: MRI

70545

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: MR or ARMRIT: MRI

70546

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: MR or ARMRIT: MRI

70547

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: MR or ARMRIT: MRI

70548

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: MR or ARMRIT: MRI

70549

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: MR or ARMRIT: MRI

70551

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: MR or ARMRIT: MRI

70552

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: MR or ARMRIT: MRI

70553

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: MR or ARMRIT: MRI

70554

02

Board Certified* Radiologist

Credentialed by ARRT: MR or ARMRIT: MRI

70555

02

Board Certified* Radiologist

Credentialed by ARRT: MR or ARMRIT: MRI

71045

01

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

71046

01

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

71047

01

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

71048

01

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

71100

01

Board Certified* Radiologist

State License: General Radiographer or ARRT: R.T.-R

71101

01

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

71110

01

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

71111

01

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

71120

01

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

71130

01

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

71250

01

Board Certified* Radiologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

71260

02

Board Certified* Radiologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

71270

02

Board Certified* Radiologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

71271

09

Board Certified* Radiologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

71275

02

Board Certified* Radiologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

71550

01

Board Certified* Radiologist

Credentialed by ARRT: MR or ARMRIT: MRI

71551

02

Board Certified* Radiologist

Credentialed by ARRT: MR or ARMRIT: MRI

71552

02

Board Certified* Radiologist

Credentialed by ARRT: MR or ARMRIT: MRI

71555

02

Board Certified* Radiologist

Credentialed by ARRT: MR or ARMRIT: MRI

72020

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

72040

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

72050

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

72052

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

72070

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

72072

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

72074

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

72080

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

72081

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

72082

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

72083

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

72084

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

72100

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

72110

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

72114

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

72120

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

72125

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

72126

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

72127

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

72128

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

72129

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

72130

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

72131

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

72132

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

72133

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

72141

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: MR or ARMRIT: MRI

72142

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: MR or ARMRIT: MRI

72146

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: MR or ARMRIT: MRI

72147

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: MR or ARMRIT: MRI

72148

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: MR or ARMRIT: MRI

72149

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: MR or ARMRIT: MRI

72156

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: MR or ARMRIT: MRI

72157

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: MR or ARMRIT: MRI

72158

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: MR or ARMRIT: MRI

72159

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: MR or ARMRIT: MRI

72170

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

72190

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

72191

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

72192

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

72193

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

72194

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

72195

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: MR or ARMRIT: MRI

72196

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: MR or ARMRIT: MRI

72197

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: MR or ARMRIT: MRI

72198

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: MR or ARMRIT: MRI

72200

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

72202

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

72220

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

72240

03

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

72255

03

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

72265

03

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

72270

03

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

72285

03

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

72295

03

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73000

01

Board Certified* Radiologist or Orthopaedic Surgeon

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73010

01

Board Certified* Radiologist or Orthopaedic Surgeon

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73020

01

Board Certified* Radiologist or Orthopaedic Surgeon

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73030

01

Board Certified* Radiologist or Orthopaedic Surgeon

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73040

03

Board Certified* Radiologist or Orthopaedic Surgeon

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73050

01

Board Certified* Radiologist or Orthopaedic Surgeon

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73060

01

Board Certified* Radiologist or Orthopaedic Surgeon

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73070

01

Board Certified* Radiologist or Orthopaedic Surgeon

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73080

01

Board Certified* Radiologist or Orthopaedic Surgeon

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73085

03

Board Certified* Radiologist or Orthopaedic Surgeon

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73090

01

Board Certified* Radiologist or Orthopaedic Surgeon

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73092

01

Board Certified* Radiologist or Orthopaedic Surgeon

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73100

01

Board Certified* Radiologist or Orthopaedic Surgeon

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73110

01

Board Certified* Radiologist or Orthopaedic Surgeon

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73115

03

Board Certified* Radiologist or Orthopaedic Surgeon

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73120

01

Board Certified* Radiologist or Orthopaedic Surgeon

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73130

01

Board Certified* Radiologist or Orthopaedic Surgeon

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73140

01

Board Certified* Radiologist or Orthopaedic Surgeon

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73200

01

Board Certified* Radiologist or Orthopaedic Surgeon

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

73201

02

Board Certified* Radiologist or Orthopaedic Surgeon

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

73202

02

Board Certified* Radiologist or Orthopaedic Surgeon

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

73206

02

Board Certified* Radiologist or Orthopaedic Surgeon

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

73218

01

Board Certified* Radiologist or Orthopaedic Surgeon

Credentialed by ARRT: MR or ARMRIT: MRI

73219

02

Board Certified* Radiologist or Orthopaedic Surgeon

Credentialed by ARRT: MR or ARMRIT: MRI

73220

02

Board Certified* Radiologist or Orthopaedic Surgeon

Credentialed by ARRT: MR or ARMRIT: MRI

73221

01

Board Certified* Radiologist or Orthopaedic Surgeon

Credentialed by ARRT: MR or ARMRIT: MRI

73222

02

Board Certified* Radiologist or Orthopaedic Surgeon

Credentialed by ARRT: MR or ARMRIT: MRI

73223

02

Board Certified* Radiologist or Orthopaedic Surgeon

Credentialed by ARRT: MR or ARMRIT: MRI

73225

02

Board Certified* Radiologist

Credentialed by ARRT: MR or ARMRIT: MRI

73501

01

Board Certified* Radiologist or Orthopaedic Surgeon

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73502

01

Board Certified* Radiologist or Orthopaedic Surgeon

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73503

01

Board Certified* Radiologist or Orthopaedic Surgeon

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73521

01

Board Certified* Radiologist or Orthopaedic Surgeon

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73522

01

Board Certified* Radiologist or Orthopaedic Surgeon

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73523

01

Board Certified* Radiologist or Orthopaedic Surgeon

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73525

03

Board Certified* Radiologist or Orthopaedic Surgeon

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73551

01

Board Certified* Radiologist or Orthopaedic Surgeon

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73552

01

Board Certified* Radiologist or Orthopaedic Surgeon

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73560

01

Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73562

09

Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73564

01

Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73565

01

Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73580

03

Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73590

01

Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73592

01

Board Certified* Radiologist or Orthopaedic Surgeon

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73600

01

Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73610

01

Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73615

03

Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73620

01

Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73630

01

Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73650

01

Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73660

01

Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

73700

01

Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

73701

02

Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

73702

02

Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

73706

02

Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

73718

01

Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist

Credentialed by ARRT: MR or ARMRIT: MRI

73719

02

Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist

Credentialed by ARRT: MR or ARMRIT: MRI

73720

02

Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist

Credentialed by ARRT: MR or ARMRIT: MRI

73721

01

Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist

Credentialed by ARRT: MR or ARMRIT: MRI

73722

02

Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist

Credentialed by ARRT: MR or ARMRIT: MRI

73723

02

Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist

Credentialed by ARRT: MR or ARMRIT: MRI

73725

02

Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist

Credentialed by ARRT: MR or ARMRIT: MRI

74018

01

Board Certified* Radiologist or Urologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

74019

01

Board Certified* Radiologist or Urologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

74021

01

Board Certified* Radiologist or Urologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

74022

01

Board Certified* Radiologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

74150

01

Board Certified* Radiologist or Urologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

74160

02

Board Certified* Radiologist or Urologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

74170

02

Board Certified* Radiologist or Urologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

74174

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

74175

02

Board Certified* Radiologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

74176

01

Board Certified* Radiologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

74177

02

Board Certified* Radiologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

74178

02

Board Certified* Radiologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

74181

01

Board Certified* Radiologist

Credentialed by ARRT: MR or ARMRIT: MRI

74182

02

Board Certified* Radiologist

Credentialed by ARRT: MR or ARMRIT: MRI

74183

02

Board Certified* Radiologist

Credentialed by ARRT: MR or ARMRIT: MRI

74185

02

Board Certified* Radiologist

Credentialed by ARRT: MR or ARMRIT: MRI

74190

03

Board Certified* Radiologist

Credentialed by ARRT: MR or ARMRIT: MRI

74210

03

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

74220

03

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

74221

03

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

74230

03

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

74240

03

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

74246

03

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

74248

03

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

74250

02

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

74251

03

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

74261

02

Board Certified* Gastroenterologist or Radiologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

74262

02

Board Certified* Gastroenterologist or Radiologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

74270

03

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

74280

03

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

74290

01

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

74300

03

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

74301

03

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

74328

03

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

74329

03

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

74330

03

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

74400

02

Board Certified* Radiologist or Urologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

74410

02

Board Certified* Radiologist or Urologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

74415

02

Board Certified* Radiologist or Urologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

74420

03

Board Certified* Radiologist or Urologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

74425

03

Board Certified* Radiologist or Urologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

74430

03

Board Certified* Radiologist or Urologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

74440

03

Board Certified* Radiologist or Urologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

74445

03

Board Certified* Radiologist or Urologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

74450

03

Board Certified* Radiologist or Urologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

74455

03

Board Certified* Radiologist or Urologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

74470

03

Board Certified* Radiologist or Urologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

74712

02

Board Certified* Radiologist or Gynecologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

74713

02

Board Certified* Radiologist or Gynecologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

74740

03

Board Certified* Radiologist or Gynecologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

74742

03

Board Certified* Radiologist or Gynecologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

74775

03

Board Certified* Radiologist or Gynecologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75557

01

Board Certified* Radiologist

Credentialed by ARRT: MR or ARMRIT: MRI

75559

02

Board Certified* Radiologist

Credentialed by ARRT: MR or ARMRIT: MRI

75561

01

Board Certified* Radiologist

Credentialed by ARRT: MR or ARMRIT: MRI

75563

01

Board Certified* Radiologist

Credentialed by ARRT: MR or ARMRIT: MRI

75565

01

Board Certified* Radiologist

Credentialed by ARRT: MR or ARMRIT: MRI

75571

09

Board Certified* Cardiologist or Radiologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

75572

02

Board Certified* Cardiologist or Radiologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

75573

02

Board Certified* Cardiologist or Radiologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

75574

02

Board Certified* Cardiologist or Radiologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

75580

01

Board Certified* Cardiologist or Radiologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

75600

03

Board Certified* Radiologist or Vascular Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75605

03

Board Certified* Radiologist or Vascular Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75625

03

Board Certified* Radiologist or Vascular Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75630

03

Board Certified* Radiologist or Vascular Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75635

02

Board Certified* Radiologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

75705

03

Board Certified* Radiologist, Vascular Surgeon or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75710

03

Board Certified* Radiologist, Cardiologist or Vascular Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75716

03

Board Certified* Radiologist, Cardiologist or Vascular Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75726

03

Board Certified* Radiologist or Vascular Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75731

03

Board Certified* Radiologist or Vascular Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75733

03

Board Certified* Radiologist or Vascular Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75736

03

Board Certified* Radiologist or Vascular Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75741

03

Board Certified* Radiologist or Vascular Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75743

03

Board Certified* Radiologist or Vascular Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75746

03

Board Certified* Radiologist or Vascular Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75756

03

Board Certified* Radiologist or Vascular Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75774

03

Board Certified* Radiologist, Vascular Surgeon or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75801

03

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75803

03

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75805

03

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75807

03

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75809

03

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75810

03

Board Certified* Radiologist or Vascular Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75820

03

Board Certified* Radiologist or Vascular Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75822

03

Board Certified* Radiologist or Vascular Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75825

03

Board Certified* Radiologist or Vascular Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75827

03

Board Certified* Radiologist or Vascular Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75831

03

Board Certified* Radiologist or Vascular Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75833

03

Board Certified* Radiologist or Vascular Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75840

03

Board Certified* Radiologist or Vascular Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75842

03

Board Certified* Radiologist or Vascular Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75860

03

Board Certified* Radiologist, Vascular Surgeon or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75870

03

Board Certified* Radiologist, Vascular Surgeon or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75872

03

Board Certified* Radiologist, Vascular Surgeon or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75880

03

Board Certified* Radiologist, Vascular Surgeon or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75885

03

Board Certified* Radiologist or Vascular Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75887

03

Board Certified* Radiologist or Vascular Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75889

03

Board Certified* Radiologist or Vascular Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R

75891

03

Board Certified* Radiologist or Vascular Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R

76000

03

Board Certified* Radiologist or Urologist or in the field related to the Primary Procedure

State License: General Radiographer or Credentialed by ARRT: R.T.-R

76010

01

Board Certified* Radiologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

76080

03

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Credentialed by ARRT: R.T.-R

76098

01

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

76100

01

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

76120

02

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

76125

02

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

76376

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT or ARRT: MR or ARMRIT: MRI or ARDMS: RDMS or ARRT: R.T.-S (as applicable)

76377

03

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT or ARRT: MR or ARMRIT: MRI or ARDMS: RDMS or ARRT: R.T.-S (as applicable)

76380

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

76390

01

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: MR or ARMRIT: MRI

76391

02

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: MR or ARMRIT: MRI

76506

01

Board Certified* Radiologist or Neurologist

Credentialed by ARDMS: RDMS-NE or ARRT: R.T.-S

76510

02

Board Certified* Ophthalmologist, Radiologist or Optometrist

Credentialed by ARDMS: RDMS-OP or JCAHPO: COT or COMT

76511

02

Board Certified* Ophthalmologist, Radiologist or Optometrist

Credentialed by ARDMS: RDMS-OP or JCAHPO: COT or COMT

76512

02

Board Certified* Ophthalmologist, Radiologist or Optometrist

Credentialed by ARDMS: RDMS-OP or JCAHPO: COT or COMT

76513

02

Board Certified* Ophthalmologist, Radiologist or Optometrist

Credentialed by ARDMS: RDMS-OP or JCAHPO: COT or COMT

76514

01

Board Certified* Ophthalmologist, Radiologist or Optometrist

Credentialed by ARDMS: RDMS-OP or JCAHPO: COT or COMT

76516

01

Board Certified* Ophthalmologist, Radiologist or Optometrist

Credentialed by ARDMS: ROUB or RDMS-OP or JCAHPO: COT or COMT

76519

01

Board Certified* Ophthalmologist, Radiologist or Optometrist

Credentialed by ARDMS: ROUB or RDMS- OP or JCAHPO: COT or COMT

76529

01

Board Certified* Ophthalmologist or Radiologist

Credentialed by ARDMS: ROUB or RDMS- OP or JCAHPO: COT or COMT

76536

01

Board Certified* Radiologist or Neurologist

Credentialed by ARDMS: RDMS or ARRT: R.T.-S

76604

01

Board Certified* Radiologist

Credentialed by ARDMS: RDMS or ARRT: R.T.-S

76641

01

Board Certified* Radiologist

Credentialed by ARDMS: RDMS or ARRT: R.T.-S

76642

01

Board Certified* Radiologist

Credentialed by ARDMS: RDMS or ARRT: R.T.-S

76700

01

Board Certified* Radiologist or Urologist

Credentialed by ARDMS: RDMS or ARRT: R.T.-S

76705

01

Board Certified* Radiologist or Urologist

Credentialed by ARDMS: RDMS or ARRT: R.T.-S

76706

09

Board Certified* Cardiologist or Radiologist

Credentialed by ARDMS: RVT or RDMS or ARRT: R.T.-S or R.T.-VS or CCI: RVS

76770

01

Board Certified* Radiologist or Urologist

Credentialed by ARDMS: RDMS or ARRT: R.T.-S

76775

01

Board Certified* Radiologist or Urologist

Credentialed by ARDMS: RDMS or ARRT: R.T.-S

76776

01

Board Certified* Radiologist or Urologist

Credentialed by ARDMS: RDMS or ARRT: R.T.-S

76801

01

Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine

Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S

76802

01

Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine

Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S

76805

01

Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine

Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S

76810

01

Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine

Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S

76811

01

Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine

Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S

76812

01

Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine

Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S

76813

01

Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine

Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S

76814

01

Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine

Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S

76815

01

Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine

Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S

76816

01

Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine

Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S

76817

01

Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine

Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S

76818

01

Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine

Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S

76819

01

Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine

Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S

76820

01

Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine

Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S

76821

01

Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine

Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S

76825

01

Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine

Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S

76826

01

Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine

Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S

76827

01

Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine

Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S

76828

01

Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine

Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S

76830

01

Board Certified* Radiologist, Urologist or Obstetrics/Gynecologist

Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S

76831

03

Board Certified* Radiologist

Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S

76856

01

Board Certified* Radiologist, Urologist or Obstetrics/Gynecologist

Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S

76857

01

Board Certified* Radiologist, Urologist or Obstetrics/Gynecologist

Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S

76870

01

Board Certified* Radiologist or Urologist

Credentialed by ARDMS: RDMS or ARRT: R.T.-S

76872

01

Board Certified* Radiologist or Urologist

Credentialed by ARDMS: RDMS or ARRT: R.T.-S

76873

02

Board Certified* Radiologist or Urologist

Credentialed by ARDMS: RDMS or ARRT: R.T.-S

76881

09

Board Certified* Radiologist or Podiatrist

Credentialed by ARDMS: RDMS or ARRT: R.T.-S

76882

09

Board Certified* Radiologist or Podiatrist

Credentialed by ARDMS: RDMS or ARRT: R.T.-S

76883

09

Board Certified* Radiologist or Podiatrist

Credentialed by ARDMS: RDMS or ARRT: R.T.-S

76885

01

Board Certified* Radiologist

Credentialed by ARDMS: RDMS or ARRT: R.T.-S

76886

01

Board Certified* Radiologist

Credentialed by ARDMS: RDMS or ARRT: R.T.-S

76942

03

Board Certified* Radiologist, Podiatrist, or Urologist

Credentialed by ARDMS: RDMS or ARRT: R.T.-S

76946

03

Board Certified* Radiologist

Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S

76975

03

Board Certified* Radiologist

Credentialed by ARDMS: RDMS or ARRT: R.T.-S

76977

01

Board Certified* Radiologist, Podiatrist or Urologist

Credentialed by ARDMS: RDMS or ARRT: R.T.-S or -BD

76978

03

Board Certified* Radiologist

Credentialed by ARDMS: RDMS or ARRT: R.T.-S

76979

03

Board Certified* Radiologist

Credentialed by ARDMS: RDMS or ARRT: R.T.-S

77002

03

Board Certified* Radiologist or in the field related to the Primary Procedure

State License: General Radiographer or Credentialed by ARRT: R.T.-R

77003

03

Board Certified* Radiologist or in the field related to the Primary Procedure

State License: General Radiographer or Credentialed by ARRT: R.T.-R

77012

03

Board Certified* Radiologist, Podiatrist or Urologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

77014

02

Board Certified* Radiologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

77021

03

Board Certified* Radiologist or Podiatrist

Credentialed by ARRT: MR or ARMRIT: MRI

77046

02

Board Certified* Radiologist

Credentialed by ARRT: MR or ARMRIT: MRI

77047

02

Board Certified* Radiologist

Credentialed by ARRT: MR or ARMRIT: MRI

77048

02

Board Certified* Radiologist

Credentialed by ARRT: MR or ARMRIT: MRI

77049

02

Board Certified* Radiologist

Credentialed by ARRT: MR or ARMRIT: MRI

77053

03

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-M

77054

03

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-M

77063

09

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-M

77065

09

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-M

77066

09

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-M

77067

09

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-M

77071

03

Board Certified* Radiologist or Podiatrist

Physician Service Code – Must be performed by a physician

77072

01

Board Certified* Radiologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

77073

01

Board Certified* Radiologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

77074

01

Board Certified* Radiologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

77075

01

Board Certified* Radiologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

77076

01

Board Certified* Radiologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

77077

01

Board Certified* Radiologist or Podiatrist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

77078

01

Board Certified* Radiologist or Urologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

77080

01

Board Certified* Radiologist, Internal Medicine Specialist, Urologist or Orthopaedic Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-BD or ISCD: CBDT

77081

01

Board Certified* Radiologist, Internal Medicine Specialist, Urologist or Orthopaedic Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-BD or ISCD: CBDT

77084

01

Board Certified* Radiologist

Credentialed by ARRT: MR or ARMRIT: MRI

77085

01

Board Certified* Radiologist, Internal Medicine Specialist, Urologist or Orthopaedic Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-BD or ISCD: CBDT

77086

01

Board Certified* Radiologist, Internal Medicine Specialist, Urologist or Orthopaedic Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-BD or ISCD: CBDT

77417

01

Board Certified* Radiologist

State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R

78012

09

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78013

09

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78014

09

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78015

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78016

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78018

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78020

09

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78070

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78071

09

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78072

09

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78075

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78102

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78103

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78104

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78110

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78111

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78120

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78121

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78122

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78130

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78140

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78185

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78191

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78195

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78201

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78202

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78215

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78216

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78226

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78227

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78230

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78231

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78232

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78258

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78261

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78262

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78264

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78265

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78266

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78267

09

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78268

09

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78278

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78282

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78290

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78291

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78300

01

Board Certified* Nuclear Medicine, Radiology or Podiatrist

Credentialed by ARRT: N or NMTCB: CNMT

78305

01

Board Certified* Nuclear Medicine, Radiology or Podiatrist

Credentialed by ARRT: N or NMTCB: CNMT

78306

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78315

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78350

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78414

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78428

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78429

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78430

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78431

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78432

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78433

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78434

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78445

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78451

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78452

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78453

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78454

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78456

09

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78457

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78458

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78459

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78466

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78468

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78469

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78472

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78473

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78481

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78483

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78491

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78492

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78494

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78496

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78579

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78580

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78582

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or MTCB: CNMT

78597

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78598

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78600

01

Board Certified* Nuclear Medicine, Radiology or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: N or NMTCB: CNMT

78601

01

Board Certified* Nuclear Medicine, Radiology or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: N or NMTCB: CNMT

78605

01

Board Certified* Nuclear Medicine, Radiology or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: N or NMTCB: CNMT

78606

01

Board Certified* Nuclear Medicine, Radiology or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: N or NMTCB: CNMT

78608

01

Board Certified* Nuclear Medicine, Radiology or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: N or NMTCB: CNMT

78610

01

Board Certified* Nuclear Medicine, Radiology or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: N or NMTCB: CNMT

78630

01

Board Certified* Nuclear Medicine, Radiology or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: N or NMTCB: CNMT

78635

01

Board Certified* Nuclear Medicine, Radiology or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: N or NMTCB: CNMT

78645

01

Board Certified* Nuclear Medicine, Radiology or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: N or NMTCB: CNMT

78650

01

Board Certified* Nuclear Medicine, Radiology or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: N or NMTCB: CNMT

78660

01

Board Certified* Nuclear Medicine, Radiology or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: N or NMTCB: CNMT

78700

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78701

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78707

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78708

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78709

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78725

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78730

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78740

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78761

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78800

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78801

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78802

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78803

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78804

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78811

01

Board Certified* Nuclear Medicine, Radiology or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: N or NMTCB: CNMT

78812

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78813

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78814

01

Board Certified* Nuclear Medicine, Radiology or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: N or NMTCB: CNMT

78815

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78816

01

Board Certified* Nuclear Medicine or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78830

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78831

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78832

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

78835

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

86485

09

Board Certified* M.D. or D.O.

Licensed Personnel

86490

09

Board Certified* M.D. or D.O.

Licensed Personnel

86580

09

Board Certified* M.D. or D.O.

Licensed Personnel

91010

02

Board Certified* Gastroenterologist

RN

91020

02

Board Certified* Gastroenterologist

RN

91022

02

Board Certified* Gastroenterologist

RN

91030

02

Board Certified* Gastroenterologist

RN

91034

02

Board Certified* Gastroenterologist

RN

91035

02

Board Certified* Gastroenterologist

RN

91037

02

Board Certified* Gastroenterologist

RN

91038

02

Board Certified* Gastroenterologist

RN

91040

02

Board Certified* Gastroenterologist

RN

91065

09

Board Certified* Gastroenterologist

RN

91110

09

Board Certified* Gastroenterologist

RN

91111

09

Board Certified* Gastroenterologist

RN

91113

09

Board Certified* Gastroenterologist

RN

91120

02

Board Certified* Gastroenterologist Colorectal Surgeon

RN

91122

02

Board Certified* Gastroenterologist Colorectal Surgeon

RN

91132

01

Board Certified* Gastroenterologist

RN

91133

03

Board Certified* Gastroenterologist

RN

92025

09

Board Certified* Ophthalmologist, Neurologist or Optometrist

Credentialed by JCAHPO: COT or COMT

92060

01

Board Certified* Ophthalmologist, Neurologist or Optometrist

Credentialed by JCAHPO: COT or COMT

92081

01

Board Certified* Ophthalmologist, Neurologist or Optometrist

Credentialed by JCAHPO: COT or COMT

92082

01

Board Certified* Ophthalmologist, Neurologist or Optometrist

Credentialed by JCAHPO: COT or COMT

92083

01

Board Certified* Ophthalmologist, Neurologist or Optometrist

Credentialed by JCAHPO: COT or COMT

92100

09

Board Certified* Ophthalmologist or Optometrist

Physician Service Code – Must be performed by a physician

92132

01

Board Certified* Ophthalmologist or Optometrist

Credentialed by JCAHPO: COT or COMT

92133

01

Board Certified* Ophthalmologist or Optometrist

Credentialed by JCAHPO: COT or COMT

92134

01

Board Certified* Ophthalmologist or Optometrist

Credentialed by JCAHPO: COT or COMT

92136

09

Board Certified* Ophthalmologist or Optometrist

Credentialed by JCAHPO: COT or COMT

92229

09

Board Certified* Ophthalmologist or Optometrist

Credentialed by JCAHPO: COT or COMT

92230

09

Board Certified* Ophthalmologist, Neurologist or Optometrist

Credentialed by JCAHPO: COT or COMT

92235

02

Board Certified* Ophthalmologist, Neurologist or Optometrist

Credentialed by JCAHPO: COT or COMT

92240

02

Board Certified* Ophthalmologist, Neurologist or Optometrist

Credentialed by JCAHPO: COT or COMT

92242

02

Board Certified* Ophthalmologist, Neurologist or Optometrist

Credentialed by JCAHPO: COT or COMT

92250

01

Board Certified* Ophthalmologist, Neurologist or Optometrist

Credentialed by JCAHPO: COT or COMT

92265

03

Board Certified* Ophthalmologist, Neurologist, Physiatrist or Optometrist

Credentialed by JCAHPO: COT or COMT

92270

01

Board Certified* Ophthalmologist, Neurologist or Optometrist

Credentialed by JCAHPO: COT or COMT

92273

01

Board Certified* Ophthalmologist, Neurologist or Optometrist

Credentialed by JCAHPO: COT or COMT

92274

01

Board Certified* Ophthalmologist, Neurologist or Optometrist

Credentialed by JCAHPO: COT or COMT

92283

01

Board Certified* Ophthalmologist, Neurologist or Optometrist

Credentialed by JCAHPO: COT or COMT

92284

01

Board Certified* Ophthalmologist, Neurologist or Optometrist

Credentialed by JCAHPO: COT or COMT

92285

01

Board Certified* Ophthalmologist, Neurologist or Optometrist

Credentialed by JCAHPO: COT or COMT

92286

01

Board Certified* Ophthalmologist, Neurologist or Optometrist

Credentialed by JCAHPO: COT or COMT or OPS: CRA

92511

03

Board Certified* Otolaryngologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

92517

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92518

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92519

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92537

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92538

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92540

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92541

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92542

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92544

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92545

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92546

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92547

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92548

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92549

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92550

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92552

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92553

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92555

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92556

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92557

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92562

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92563

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92565

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92567

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92568

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92570

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92571

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92572

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92575

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92576

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92577

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92579

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92582

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92583

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92584

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92587

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92588

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92596

09

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92597

09

Board Certified* Neurologist or Otolaryngologist

Physician service code – must be performed by a physician

92601

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92602

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92603

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92604

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92611

09

Board Certified* Radiologist or Otolaryngologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

92620

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92621

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92625

02

Board Certified* Neurologist or Otolaryngologist

Licensed Audiologist*

92651

02

Board Certified* Neurologist, Physiatrist or Otolaryngologist

Licensed Audiologist*

92652

02

Board Certified* Neurologist, Physiatrist or Otolaryngologist

Licensed Audiologist*

92653

02

Board Certified* Neurologist, Physiatrist or Otolaryngologist

Licensed Audiologist*

93000

01

Board Certified* Internist or Cardiologist

RN, Licensed Practical Nurse (LPN)/Licensed Vocational Nurse (LVN), or State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

93005

01

Board Certified* Internist or Cardiologist

RN, LPN/LVN, or State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

93010

09

Board Certified* Internist or Cardiologist

Professional component only code – must be performed by a physician

93015

02

Board Certified* Internist, Cardiologist or Nuclear Medicine – ACLS Certified

RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET or ARRT: R.T.-N or NMTCB: CNMT

93016

02

Board Certified* Internist, Cardiologist or Nuclear Medicine – ACLS Certified

RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET or ARRT: R.T.-N or NMTCB: CNMT

93017

02

Board Certified* Internist, Cardiologist or Nuclear Medicine – ACLS Certified

RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET or ARRT: R.T.-N or NMTCB: CNMT

93018

09

Board Certified* Cardiologist or Nuclear Medicine

Professional component only code – must be performed by a physician

93024

03

Board Certified* Internist or Cardiologist – ACLS Certified

RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

93025

01

Board Certified* Internist or Cardiologist – ACLS Certified

RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

93040

01

Board Certified* Internist or Cardiologist

RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

93041

01

Board Certified* Internist or Cardiologist

RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

93042

09

Board Certified* Cardiologist

Professional Component Code – must be performed by a physician

93224

01

Board Certified* Cardiologist

RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

93225

01

Board Certified* Cardiologist

RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

93226

01

Board Certified* Cardiologist

RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

93227

09

Board Certified* Cardiologist

Professional Component Only Code – must be performed by a physician

93228

09

Board Certified* Cardiologist

Professional Component Only Code – service must be performed by a physician

93229

01

Board Certified* Cardiologist

State Licensed: RN or Paramedic or Credentialed by NHA: CET or CCI: CCT or CRAT

93241

01

Board Certified* Cardiologist

RN, State Licensed Paramedic or Credentialed by CCI: CCT or CRAT or NHA: CET

93242

01

Board Certified* Cardiologist

RN, State Licensed Paramedic or Credentialed by CCI: CCT or CRAT or NHA: CET

93243

01

Board Certified* Cardiologist

RN, State Licensed Paramedic or Credentialed by CCI: CCT or CRAT or NHA: CET

93244

09

Board Certified* Cardiologist

Professional Component Only Code – must be performed by a physician

93245

01

Board Certified* Cardiologist

RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

93246

01

Board Certified* Cardiologist

RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

93247

01

Board Certified* Cardiologist

RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

93248

09

Board Certified* Cardiologist

Professional Component Only Code – must be performed by a physician

93260

02

Board Certified* Cardiologist

RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

93261

02

Board Certified* Cardiologist

RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

93268

01

Board Certified* Cardiologist

RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

93270

01

Board Certified* Cardiologist

RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

93271

01

Board Certified* Cardiologist

RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

93272

09

Board Certified* Cardiologist

Professional Component Only Code – must be performed by a physician

93278

01

Board Certified* Cardiologist

RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

93279

02

Board Certified* Cardiologist

RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

93280

02

Board Certified* Cardiologist

RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

93281

02

Board Certified* Cardiologist

RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

93282

02

Board Certified* Cardiologist

RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

93283

02

Board Certified* Cardiologist

RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

93284

02

Board Certified* Cardiologist

RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

93285

02

Board Certified* Cardiologist

RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

93286

02

Board Certified* Cardiologist

RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

93287

02

Board Certified* Cardiologist

RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

93288

02

Board Certified* Cardiologist

RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

93289

02

Board Certified* Cardiologist

RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

93290

02

Board Certified* Cardiologist

RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

93291

02

Board Certified* Cardiologist

RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

93292

02

Board Certified* Cardiologist

RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

93293

01

Board Certified* Cardiologist

RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

93294

09

Board Certified* Cardiologist

Professional Component Only Code – service must be performed by a physician

93295

09

Board Certified* Cardiologist

Professional Component Only Code – service must be performed by a physician

93296

01

Board Certified* Cardiologist

RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

93297

09

Board Certified* Cardiologist

Professional Component Only Code – service must be performed by a physician

93298

09

Board Certified* Cardiologist

Professional Component Only Code – service must be performed by a physician

93303

01

Board Certified* Cardiologist

Credentialed by ARDMS: RDCS or CCI: RCS

93304

01

Board Certified* Cardiologist

Credentialed by ARDMS: RDCS or CCI: RCS

93306

01

Board Certified* Cardiologist

Credentialed by ARDMS: RDCS or CCI: RCS

93307

01

Board Certified* Cardiologist

Credentialed by ARDMS: RDCS or CCI: RCS

93308

01

Board Certified* Cardiologist

Credentialed by ARDMS: RDCS or CCI: RCS

93312

03

Board Certified* Cardiologist

Credentialed by ARDMS: RDCS or CCI: RCS

93313

03

Board Certified* Cardiologist

Physician Service Code – must be performed by a physician

93314

03

Board Certified* Cardiologist

Credentialed by ARDMS: RDCS or CCI: RCS

93315

03

Board Certified* Cardiologist

Credentialed by ARDMS: RDCS or CCI: RCS

93316

03

Board Certified* Cardiologist

Physician Service Code – must be performed by a physician

93317

03

Board Certified* Cardiologist

Credentialed by ARDMS: RDCS or CCI: RCS

93319

09

Board Certified* Cardiologist

Credentialed by ARDMS: RDCS or CCI: RCS

93320

01

Board Certified* Cardiologist

Credentialed by ARDMS: RDCS or CCI: RCS

93321

01

Board Certified* Cardiologist

Credentialed by ARDMS: RDCS or CCI: RCS

93325

01

Board Certified* Cardiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine

Credentialed by ARDMS: RDCS or CCI: RCS

93350

02

Board Certified* Cardiologist

RN or State Licensed Paramedic or Credentialed by ARDMS: RDCS or CCI: RCS

93351

02

Board Certified* Cardiologist

State Licensed RN or Paramedic, or Credentialed by ARDMS: RDCS or CCI: RCS

93352

09

Board Certified* Cardiologist

Physician Service Code – service must be performed by a physician

93451

03

Board Certified* Cardiologist with Level 02 Training (minimum) as outlined by the ACC/AHA Task Force 3

Credentialed by: ARRT: CI or CCI: RCIS

93452

03

Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3

Credentialed by: ARRT: CI or CCI: RCIS

93453

03

Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3

Credentialed by: ARRT: CI or CCI: RCIS

93454

03

Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3

Credentialed by: ARRT: CI or CCI: RCIS

93455

03

Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3

Credentialed by: ARRT: CI or CCI: RCIS

93456

03

Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3

Credentialed by: ARRT: CI or CCI: RCIS

93457

03

Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3

Credentialed by: ARRT: CI or CCI: RCIS

93458

03

Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3

Credentialed by: ARRT: CI or CCI: RCIS

93459

03

Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3

Credentialed by: ARRT: CI or CCI: RCIS

93460

03

Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3

Credentialed by: ARRT: CI or CCI: RCIS

93461

03

Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3

Credentialed by: ARRT: CI or CCI: RCIS

93571

03

Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3

Credentialed by: ARRT: CI or CCI: RCIS

93572

03

Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3

Credentialed by: ARRT: CI or CCI: RCIS

93584

09

Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3

Credentialed by: ARRT: CI or CCI: RCIS

93585

09

Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3

Credentialed by: ARRT: CI or CCI: RCIS

93586

09

Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3

Credentialed by: ARRT: CI or CCI: RCIS

93587

09

Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3

Credentialed by: ARRT: CI or CCI: RCIS

93588

09

Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3

Credentialed by: ARRT: CI or CCI: RCIS

93593

03

Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3

Credentialed by: ARRT: CI or CCI: RCIS

93594

03

Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3

Credentialed by: ARRT: CI or CCI: RCIS

93595

03

Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3

Credentialed by: ARRT: CI or CCI: RCIS

93596

03

Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3

Credentialed by: ARRT: CI or CCI: RCIS

93597

03

Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3

Credentialed by: ARRT: CI or CCI: RCIS

93598

03

Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3

Credentialed by: ARRT: CI or CCI: RCIS

93660

02

Board Certified* Cardiologist

Credentialed by NHA: CET or CCI: CCT, RCIS, RCS or ARDMS: RDCS or RN

93701

09

Board Certified* Cardiologist

Demonstrates Proficiency

93740

09

Board Certified* Cardiologist

Credentialed by CCI: CCT, NHA: CET, State licensed Paramedic or RN

93770

09

Board Certified* Cardiologist

Credentialed by CCI: CCT, NHA: CET, State Licensed Paramedic or RN

93784

01

Board Certified* Cardiologist, Internal Medicine or Family Practice

Credentialed by CCI: CCT, NHA: CET, State Licensed Paramedic or RN

93786

01

Board Certified* Cardiologist, Internal Medicine or Family Practice

Credentialed by CCI: CCT, NHA: CET, State Licensed Paramedic or RN

93788

09

Board Certified* Cardiologist, Internal Medicine or Family Practice

Credentialed by CCI: CCT, NHA: CET, State Licensed Paramedic or RN

93790

09

Board Certified* Cardiologist, Internal Medicine or Family Practice

Professional Component Only Code – must be performed by a physician

93792

01

Board Certified* Cardiologist

RN

93880

01

Board Certified* Radiologist, Neurologist, Cardiologist, Vascular Surgeon or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS

93882

01

Board Certified* Radiologist, Neurologist, Cardiologist, Vascular Surgeon or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS

93886

01

Board Certified* Radiologist, Neurologist, Cardiologist or Vascular Surgeon

Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS

93888

01

Board Certified* Radiologist, Neurologist, Cardiologist or Vascular Surgeon

Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS

93890

01

Board Certified* Radiologist, Neurologist, Cardiologist or Vascular Surgeon

Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS

93892

01

Board Certified* Radiologist, Neurologist, Cardiologist or Vascular Surgeon

Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS

93893

01

Board Certified* Radiologist, Neurologist, Cardiologist or Vascular Surgeon

Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS

93922

01

Board Certified* Radiologist, Cardiologist, Podiatrist or Vascular Surgeon

Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS

93923

01

Board Certified* Radiologist, Cardiologist, Podiatrist or Vascular Surgeon

Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS

93924

01

Board Certified* Radiologist, Cardiologist, Podiatrist or Vascular Surgeon

Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS

93925

01

Board Certified* Radiologist, Cardiologist, Podiatrist or Vascular Surgeon

Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS

93926

01

Board Certified* Radiologist, Cardiologist, Podiatrist or Vascular Surgeon

Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS

93930

01

Board Certified* Radiologist, Cardiologist or Vascular Surgeon

Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS

93931

01

Board Certified* Radiologist, Cardiologist or Vascular Surgeon

Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS

93970

01

Board Certified* Radiologist, Cardiologist or Vascular Surgeon

Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS

93971

01

Board Certified* Radiologist, Cardiologist or Vascular Surgeon

Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS

93975

01

Board Certified* Radiologist, Vascular Surgeon, Urologist or Obstetrics/Gynecologist

Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS

93976

01

Board Certified* Radiologist, Vascular Surgeon, Urologist or Obstetrics/Gynecologist

Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS

93978

01

Board Certified* Radiologist or Vascular Surgeon

Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS

93979

01

Board Certified* Radiologist or Vascular Surgeon

Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS

93980

01

Board Certified* Radiologist, Urologist or Vascular Surgeon

Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS

93981

01

Board Certified* Radiologist, Urologist or Vascular Surgeon

Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS

93985

01

Board Certified* Radiologist, Urologist or Vascular Surgeon

Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS

93986

01

Board Certified* Radiologist, Urologist or Vascular Surgeon

Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS

93990

01

Board Certified* Radiologist or Vascular Surgeon

Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS

94010

01

Board Certified* Pulmonologist

State License: Respiratory Therapist or RN

94014

01

Board Certified* Pulmonologist

State License: Respiratory Therapist or RN

94015

01

Board Certified* Pulmonologist

State License: Respiratory Therapist or RN

94016

09

Board Certified* Pulmonologist

Professional Component Only Code – must be performed by a physician

94060

02

Board Certified* Pulmonologist

State License: Respiratory Therapist or RN

94070

02

Board Certified* Pulmonologist

State License: Respiratory Therapist or RN

94150

01

Board Certified* Pulmonologist

State License: Respiratory Therapist

94200

01

Board Certified* Pulmonologist

State License: Respiratory Therapist

94375

01

Board Certified* Pulmonologist

State License: Respiratory Therapist

94450

02

Board Certified* Pulmonologist

State License: Respiratory Therapist

94452

02

Board Certified* Pulmonologist

State License: Respiratory Therapist or RN

94453

02

Board Certified* Pulmonologist

State License: Respiratory Therapist or RN

94617

01

Board Certified* Pulmonologist

State License: Respiratory Therapist or RN

94618

01

Board Certified* Pulmonologist

State License: Respiratory Therapist or RN

94619

01

Board Certified* Pulmonologist

State License: Respiratory Therapist or RN

94621

02

Board Certified* Pulmonologist

State License: Respiratory Therapist or RN

94664

02

Board Certified* Pulmonologist

State License: Respiratory Therapist or RN

94680

02

Board Certified* Pulmonologist

State License: Respiratory Therapist

94681

02

Board Certified* Pulmonologist

State License: Respiratory Therapist

94690

01

Board Certified* Pulmonologist

State License: Respiratory Therapist

94726

01

Board Certified* Pulmonologist

State License: Respiratory Therapist

94727

01

Board Certified* Pulmonologist

State License: Respiratory Therapist

94728

01

Board Certified* Pulmonologist

State License: Respiratory Therapist

94729

01

Board Certified* Pulmonologist

State License: Respiratory Therapist

94760

01

Board Certified* Pulmonologist

Demonstrates Proficiency

94761

01

Board Certified* Pulmonologist

Demonstrates Proficiency

94762

01

Board Certified* Pulmonologist

Demonstrates Proficiency

94772

01

Board Certified* Pulmonologist

State License: Respiratory Therapist

94774

09

Board Certified* Pulmonologist

Credentialed by NBRC: CRT, RRT, CPFT, or RPFT

94775

09

Board Certified* Pulmonologist

Credentialed by NBRC: CRT, RRT, CPFT, or RPFT

94776

09

Board Certified* Pulmonologist

Credentialed by NBRC: CRT, RRT, CPFT, or RPFT

94777

09

Board Certified* Pulmonologist

Credentialed by NBRC: CRT, RRT, CPFT, or RPFT

95004

02

Board Certified* Allergy, Asthma and Immunology or Otolaryngology

RN

95024

02

Board Certified* Allergy, Asthma and Immunology or Otolaryngology

RN

95027

02

Board Certified* Allergy, Asthma and Immunology or Otolaryngology

RN

95028

02

Board Certified* Otolaryngologist

RN

95044

02

Board Certified* Otolaryngologist

RN

95052

02

Board Certified* Otolaryngologist

RN

95056

02

Board Certified* Otolaryngologist

RN

95060

03

Board Certified* Otolaryngologist, Ophthalmologist or Optometrist

RN

95065

03

Board Certified* Otolaryngologist

RN

95070

02

Board Certified* Otolaryngologist

RN

95700

01

Board Certified* Neurologist

Credentialed by ABRET: R. EEG T

95705

01

Board Certified* Neurologist

Credentialed by ABRET: R. EEG T

95706

01

Board Certified* Neurologist

Credentialed by ABRET: R. EEG T

95707

01

Board Certified* Neurologist

Credentialed by ABRET: R. EEG T

95708

01

Board Certified* Neurologist

Credentialed by ABRET: R. EEG T

95709

01

Board Certified* Neurologist

Credentialed by ABRET: R. EEG T

95710

01

Board Certified* Neurologist

Credentialed by ABRET: R. EEG T

95711

01

Board Certified* Neurologist

Credentialed by ABRET: R. EEG T

95712

01

Board Certified* Neurologist

Credentialed by ABRET: R. EEG T

95713

01

Board Certified* Neurologist

Credentialed by ABRET: R. EEG T

95714

01

Board Certified* Neurologist

Credentialed by ABRET: R. EEG T

95715

01

Board Certified* Neurologist

Credentialed by ABRET: R. EEG T

95716

01

Board Certified* Neurologist

Credentialed by ABRET: R. EEG T

95717

09

Board Certified* Neurologist

Credentialed by ABRET: R. EEG T

95718

09

Board Certified* Neurologist

Credentialed by ABRET: R. EEG T

95719

09

Board Certified* Neurologist

Credentialed by ABRET: R. EEG T

95720

09

Board Certified* Neurologist

Credentialed by ABRET: R. EEG T

95721

09

Board Certified* Neurologist

Credentialed by ABRET: R. EEG T

95722

09

Board Certified* Neurologist

Credentialed by ABRET: R. EEG T

95723

09

Board Certified* Neurologist

Credentialed by ABRET: R. EEG T

95724

09

Board Certified* Neurologist

Credentialed by ABRET: R. EEG T

95725

09

Board Certified* Neurologist

Credentialed by ABRET: R. EEG T

95726

09

Board Certified* Neurologist

Credentialed by ABRET: R. EEG T

95782

01

Physician Certified by ABSM or ABMS: Sleep Medicine OR ABFM, ABIM, ABOHNS, ABPN or AOA: Sleep Medicine Subspecialty Certification

Credentialed by BRPT: RPSGT or CPSGT, ABRET: R. EEG T. (Polysomnography) or NBRC: CRT, SDS or RRT

95783

01

Physician Certified by ABSM or ABMS: Sleep Medicine OR ABFM, ABIM, ABOHNS, ABPN or AOA: Sleep Medicine Subspecialty Certification

Credentialed by BRPT: RPSGT or CPSGT, ABRET: R. EEG T. (Polysomnography) or NBRC: CRT, SDS or RRT

95800

09

Physician Certified by ABSM or ABMS: Sleep Medicine OR ABFM, ABIM, ABOHNS, ABPN or AOA: Sleep Medicine Subspecialty Certification

Credentialed by BRPT: RPSGT or CPSGT, ABRET: R. EEG T. (Polysomnography) or NBRC: CRT, SDS or RRT

95801

09

Physician Certified by ABSM or ABMS: Sleep Medicine OR ABFM, ABIM, ABOHNS, ABPN or AOA: Sleep Medicine Subspecialty Certification

Credentialed by BRPT: RPSGT or CPSGT, ABRET: R. EEG T. (Polysomnography) or NBRC: CRT, SDS or RRT

95805

01

Physician Certified by ABSM or ABMS: Sleep Medicine OR ABFM, ABIM, ABOHNS, ABPN, or AOA: Sleep Medicine Subspecialty Certification

Credentialed by BRPT: RPSGT or CPSGT, ABRET: R. EEG T. (Polysomnography) or NBRC: CRT, SDS or RRT

95806

01

Physician Certified by ABSM or ABMS: Sleep Medicine OR ABFM, ABIM, ABOHNS, ABPN or AOA: Sleep Medicine Subspecialty Certification

Credentialed by BRPT: RPSGT or CPSGT, ABRET: R. EEG T. (Polysomnography) or NBRC: CRT, SDS or RRT

95807

01

Physician Certified by ABSM or ABMS: Sleep Medicine OR ABFM, ABIM, ABOHNS, ABPN, or AOA: Sleep Medicine Subspecialty Certification

Credentialed by BRPT: RPSGT or CPSGT, ABRET: R. EEG T. (Polysomnography) or NBRC: CRT, SDS or RRT

95808

01

Physician Certified by ABSM or ABMS: Sleep Medicine OR ABFM, ABIM, ABOHNS, ABPN, or AOA: Sleep Medicine Subspecialty Certification

Credentialed by BRPT: RPSGT or CPSGT, ABRET: R. EEG T. (Polysomnography) or NBRC: CRT, SDS or RRT

95810

01

Physician Certified by ABSM or ABMS: Sleep Medicine OR ABFM, ABIM, ABOHNS, ABPN, or AOA: Sleep Medicine Subspecialty Certification

Credentialed by BRPT: RPSGT or CPSGT, ABRET: R. EEG T. (Polysomnography) or NBRC: CRT, SDS or RRT

95811

01

Physician Certified by ABSM or ABMS: Sleep Medicine OR ABFM, ABIM, ABOHNS, ABPN, or AOA: Sleep Medicine Subspecialty Certification

Credentialed by BRPT: RPSGT or CPSGT, ABRET: R. EEG T. (Polysomnography) or NBRC: CRT, SDS or RRT

95812

01

Board Certified* Neurologist

Credentialed by ABRET: R. EEG T

95813

01

Board Certified* Neurologist

Credentialed by ABRET: R. EEG T

95816

09

Board Certified* Neurologist

Credentialed by ABRET: R. EEG T

95819

09

Board Certified* Neurologist

Credentialed by ABRET: R. EEG T

95822

09

Board Certified* Neurologist

Credentialed by ABRET: R. EEG T

95824

01

Board Certified* Neurologist

Credentialed by ABRET: R. EEG T

95830

09

Board Certified* Neurologist

Physician Service Code – must be performed by a physician

95860

6A

Board Certified* Neurologist or Physical Medicine and Rehabilitation (PMR) Physician with additional certification by: a) American Board of Electrodiagnostic Medicine, b) Clinical Neurophysiology, or c) American Board of Neurophysiology; or a Physical Therapist who is certified by the American Board of Physical Therapy Specialties (ABPTS) as a qualified clinical electrophysiology specialist and is permitted to provide the service under state law.

Procedure must be personally performed by a qualified physician who may or may not be the supervising physician. The qualified performing physician when assisted must provide personal supervision during the performance of EMG test(s) to the IDTF technician providing assistance*. In addition, EMG procedures may be personally performed by a Physical Therapist (PT) with ABPTS certification and certification in this specific procedure.

*The following are considered appropriate credentials to assist a physician performing an EMG: AAET: R. NCS.T, ABEM: CNCT or State Licensed Physical Therapist with ABPTS certification.

95861

6A

Board Certified* Neurologist; or Physical Medicine and Rehabilitation (PMR) Physician with additional certification by: a) American Board of Electrodiagnostic Medicine, b) Clinical Neurophysiology, or c) American Board of Neurophysiology; or a Physical Therapist 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.

Procedure must be personally performed by a qualified physician who may or may not be the supervising physician. The qualified performing physician when assisted must provide personal supervision during the performance of EMG test(s) to the IDTF technician providing assistance*. In addition, EMG procedures may be personally performed by a Physical Therapist (PT) with ABPTS certification and certification in this specific procedure.

*The following are considered appropriate credentials to assist a physician performing an EMG: AAET: R. NCS.T, ABEM: CNCT or State Licensed Physical Therapist with ABPTS certification.

95863

6A

Board Certified* Neurologist; or Physical Medicine and Rehabilitation (PMR) Physican with additional certification by: a) American Board of Electrodiagnostic Medicine, b) Clinical Neurophysiology, or c) American Board of Neurophysiology; or a Physical Therapist who is certified by the American Board of Physical Therapy Specialties (ABPTS) as a qualified clinical electrophysiology specialist and is permitted to provide the service under state law.

Procedure must be personally performed by a qualified physician who may or may not be the supervising physician. The qualified performing physician when assisted must provide personal supervision during the performance of EMG test(s) to the IDTF technician providing assistance*. In addition, EMG procedures may be personally performed by a Physical Therapist (PT) with ABPTS certification and certification in this specific procedure.

*The following are considered appropriate credentials to assist a physician performing an EMG: AAET: R. NCS.T, ABEM: CNCT or State Licensed Physical Therapist with ABPTS certification.

95864

6A

Board Certified* Neurologist; or Physical Medicine and Rehabilitation (PMR) Physician with additional certification by: a) American Board of Electrodiagnostic Medicine, b) Clinical Neurophysiology, or c) American Board of Neurophysiology; or a Physical Therapist who is certified by the American Board of Physical Therapy Specialties (ABPTS) as a qualified clinical electrophysiology specialist and is permitted to provide the service under state law.

Procedure must be personally performed by a qualified physician who may or may not be the supervising physician. The qualified performing physician when assisted must provide personal supervision during the performance of EMG test(s) to the IDTF technician providing assistance*. In addition, EMG procedures may be personally performed by a Physical Therapist (PT) with ABPTS certification and certification in this specific procedure.

*The following are considered appropriate credentials to assist a physician performing an EMG: AAET: R. NCS.T, ABEM: CNCT or State Licensed Physical Therapist with ABPTS certification.

95867

6A

Board Certified* Neurologist; or Physical Medicine and Rehabilitation (PMR) Physician with additional certification by: a) American Board of Electrodiagnostic Medicine, b) Clinical Neurophysiology, or c) American Board of Neurophysiology; or a Physical Therapist who is certified by the American Board of Physical Therapy Specialties (ABPTS) as a qualified clinical electrophysiology specialist and is permitted to provide the service under state law.

Procedure must be personally performed by a qualified physician who may or may not be the supervising physician. The qualified performing physician when assisted must provide personal supervision during the performance of EMG test(s) to the IDTF technician providing assistance*. In addition, EMG procedures may be personally performed by a Physical Therapist (PT) with ABPTS certification and certification in this specific procedure.

*The following are considered appropriate credentials to assist a physician performing an EMG: AAET: R. NCS.T, ABEM: CNCT or State Licensed Physical Therapist with ABPTS certification.

95868

6A

Board Certified* Neurologist; or Physical Medicine and Rehabilitation (PMR) Physician with additional certification by: a) American Board of Electrodiagnostic Medicine, b) Clinical Neurophysiology, or c) American Board of Neurophysiology; or a Physical Therapist who is certified by the American Board of Physical Therapy Specialties (ABPTS) as a qualified clinical electrophysiology specialist and is permitted to provide the service under state law.

Procedure must be personally performed by a qualified physician who may or may not be the supervising physician. The qualified performing physician when assisted must provide personal supervision during the performance of EMG test(s) to the IDTF technician providing assistance*. In addition, EMG procedures may be personally performed by a Physical Therapist (PT) with ABPTS certification and certification in this specific procedure.

*The following are considered appropriate credentials to assist a physician performing an EMG: AAET: R. NCS.T, ABEM: CNCT or State Licensed Physical Therapist with ABPTS certification.

95869

6A

Board Certified* Neurologist; or Physical Medicine and Rehabilitation (PMR) Physician with additional certification by: a) American Board of Electrodiagnostic Medicine, b) Clinical Neurophysiology, or c) American Board of Neurophysiology; or a Physical Therapist who is certified by the American Board of Physical Therapy Specialties (ABPTS) as a qualified clinical electrophysiology specialist and is permitted to provide the service under state law.

Procedure must be personally performed by a qualified physician who may or may not be the supervising physician. The qualified performing physician when assisted must provide personal supervision during the performance of EMG test(s) to the IDTF technician providing assistance*. In addition, EMG procedures may be personally performed by a Physical Therapist (PT) with ABPTS certification and certification in this specific procedure.

*The following are considered appropriate credentials to assist a physician performing an EMG: AAET: R. NCS.T, ABEM: CNCT or State Licensed Physical Therapist with ABPTS certification.

95870

6A

Board Certified* Neurologist; or Physical Medicine and Rehabilitation (PMR) Physician with additional certification by: a) American Board of Electrodiagnostic Medicine, b) Clinical Neurophysiology, or c) American Board of Neurophysiology; or a Physical Therapist who is certified by the American Board of Physical Therapy Specialties (ABPTS) as a qualified clinical electrophysiology specialist and is permitted to provide the service under state law.

Procedure must be personally performed by a qualified physician who may or may not be the supervising physician. The qualified performing physician when assisted must provide personal supervision during the performance of EMG test(s) to the IDTF technician providing assistance*. In addition, EMG procedures may be personally performed by a Physical Therapist (PT) with ABPTS certification and certification in this specific procedure.

*The following are considered appropriate credentials to assist a physician performing an EMG: AAET: R. NCS.T, ABEM: CNCT or State Licensed Physical Therapist with ABPTS certification.

95872

66

Board Certified* Neurologist; or Physical Medicine and Rehabilitation (PMR) Physician with additional certification by: a) American Board of Electrodiagnostic Medicine, b) Clinical Neurophysiology, or c) American Board of Neurophysiology; or a Physical Therapist who is certified by the American Board of Physical Therapy Specialties (ABPTS) as a qualified clinical electrophysiology specialist and is permitted to provide the service under state law.

Procedure must be personally performed by a qualified physician who may or may not be the supervising physician. The qualified performing physician when assisted must provide personal supervision during the performance of EMG test(s) to the IDTF technician providing assistance*. In addition, EMG procedures may be personally performed by a Physical Therapist (PT) with ABPTS certification and certification in this specific procedure.

*The following are considered appropriate credentials to assist a physician performing an EMG: AAET: R. NCS.T, ABEM: CNCT or State Licensed Physical Therapist with ABPTS certification.

95875

03

Board Certified* Neurologist or Physiatrist

Credentialed by ABRET: R. EP T.

95885

6A

Board Certified* Neurologist; or Physical Medicine and Rehabilitation (PMR) Physician with additional certification by: a) American Board of Electrodiagnostic Medicine, b) Clinical Neurophysiology, or c) American Board of Neurophysiology; or a Physical Therapist who is certified by the American Board of Physical Therapy Specialties (ABPTS) as a qualified clinical electrophysiology specialist and is permitted to provide the service under state law.

Procedure must be personally performed by a qualified physician who may or may not be the supervising physician. The qualified performing physician when assisted must provide personal supervision during the performance of EMG test(s) to the IDTF technician providing assistance*. In addition, EMG procedures may be personally performed by a Physical Therapist (PT) with ABPTS certification and certification in this specific procedure.

*The following are considered appropriate credentials to assist a physician performing an EMG: AAET: R. NCS.T, ABEM: CNCT or State Licensed Physical Therapist with ABPTS certification.

95886

6A

Board Certified* Neurologist; or Physical Medicine and Rehabilitation (PMR) Physician with additional certification by: a) American Board of Electrodiagnostic Medicine, b) Clinical Neurophysiology, or c) American Board of Neurophysiology; or a Physical Therapist who is certified by the American Board of Physical Therapy Specialties (ABPTS) as a qualified clinical electrophysiology specialist and is permitted to provide the service under state law.

Procedure must be personally performed by a qualified physician who may or may not be the supervising physician. The qualified performing physician when assisted must provide personal supervision during the performance of EMG test(s) to the IDTF technician providing assistance*. In addition, EMG procedures may be personally performed by a Physical Therapist (PT) with ABPTS certification and certification in this specific procedure.

*The following are considered appropriate credentials to assist a physician performing an EMG: AAET: R. NCS.T, ABEM: CNCT or State Licensed Physical Therapist with ABPTS certification.

95887

6A

Board Certified* Neurologist; or Physical Medicine and Rehabilitation (PMR) Physician with additional certification by: a) American Board of Electrodiagnostic Medicine, b) Clinical Neurophysiology, or c) American Board of Neurophysiology; or a Physical Therapist who is certified by the American Board of Physical Therapy Specialties (ABPTS) as a qualified clinical electrophysiology specialist and is permitted to provide the service under state law.

Procedure must be personally performed by a qualified physician who may or may not be the supervising physician. The qualified performing physician when assisted must provide personal supervision during the performance of EMG test(s) to the IDTF technician providing assistance*. In addition, EMG procedures may be personally performed by a Physical Therapist (PT) with ABPTS certification and certification in this specific procedure.

*The following are considered appropriate credentials to assist a physician performing an EMG: AAET: R. NCS.T, ABEM: CNCT or State Licensed Physical Therapist with ABPTS certification.

95905

01

Board Certified* Neurologist, Physiatrist or Podiatrist

Credentialed by AAET: R. NCS.T, ABRET: R. EPT, State Licensed Physical Therapist with ABPTS certification, Qualified Physical Therapist or ABEM: CNCT

95907

7A

Board Certified* Neurologist, Physiatrist or Podiatrist – General supervision level applies if PT not certified

Credentialed by AAET: R. NCS.T, ABRET: R. EPT, State Licensed Physical Therapist with ABPTS certification, Qualified Physical Therapist or ABEM: CNCT

95908

7A

Board Certified* Neurologist, Physiatrist or Podiatrist- General supervision level applies if PT not certified

Credentialed by AAET: R. NCS.T, ABRET: R. EPT, State Licensed Physical Therapist with ABPTS certification or Qualified Physical Therapist or ABEM: CNCT

95909

7A

Board Certified* Neurologist, Physiatrist or Podiatrist- General supervision level applies if PT not certified

Credentialed by AAET: R. NCS.T, ABRET: R. EPT, State Licensed Physical Therapist with ABPTS certification, Qualified Physical Therapist or ABEM: CNCT

95910

7A

Board Certified* Neurologist or Physiatrist or Podiatrist- General supervision level applies if PT not certified

Credentialed by AAET: R. NCS.T, ABRET: R. EPT, State Licensed Physical Therapist with ABPTS certification, Qualified Physical Therapist or ABEM: CNCT

95911

7A

Board Certified* Neurologist or Physiatrist or Podiatrist- General supervision level applies if PT not certified

Credentialed by AAET: R. NCS.T, ABRET: R. EPT, or State Licensed Physical Therapist with ABPTS certification, Qualified Physical Therapist or ABEM: CNCT

95912

7A

Board Certified* Neurologist or Physiatrist or Podiatrist- General supervision level applies if PT not certified

Credentialed by AAET: R. NCS.T, ABRET: R. EPT, State Licensed Physical Therapist with ABPTS certification, Qualified Physical Therapist or ABEM: CNCT

95913

7A

Board Certified* Neurologist or Physiatrist- General supervision level applies if PT not certified

Credentialed by AAET: R. NCS.T, ABRET: R. EPT, State Licensed Physical Therapist with ABPTS certification, Qualified Physical Therapist or ABEM: CNCT

95919

01

Board Certified* Neurologist or Physiatrist

Credentialed by AAET: R. NCS.T

95921

02

Board Certified* Neurologist or Physiatrist

Credentialed by AAET: R. NCS.T

95922

03

Board Certified* Neurologist or Physiatrist

Credentialed by AAET: R. NCS.T

95923

03

Board Certified* Neurologist or Physiatrist

Credentialed by AAET: R. NCS.T

95924

09

Board Certified* Neurologist or Physiatrist

Credentialed by AAET: R. NCS.T

95925

21

Board Certified* Neurologist or Physiatrist

Credentialed by ABRET: R. EP T. or R. EEG T. or State Licensed Qualified Physical Therapist or ABPTS Physical Therapist

95926

21

Board Certified* Neurologist, Physiatrist or Podiatrist

Credentialed by ABRET: R. EP T. or R. EEG T. or State Licensed Qualified Physical Therapist or ABPTS Physical Therapist

95927

21

Board Certified* Neurologist or Physiatrist

Credentialed by ABRET: R. EP T. or R. EEG T. or State Licensed Qualified Physical Therapist or ABPTS Physical Therapist

95928

09

Board Certified* Neurologist or Physiatrist

Credentialed by ABRET: R. EPT or R. EEG T.

95929

09

Board Certified* Neurologist or Physiatrist

Credentialed by ABRET: R. EPT or R. EEG T.

95930

09

Board Certified* Neurologist, Physiatrist or appropriately trained Optometrist

Credentialed by ABRET: R. EPT or R. EEG T.

95933

7A

Board Certified* Neurologist or Physiatrist – General Supervision level applies if PT not certified

Credentialed by AAET: R. NCS.T, State Licensed Physical Therapist with ABPTS certification or Qualified Physical Therapist or ABEM: CNCT

95937

7A

Board Certified* Neurologist, Physiatrist or Podiatrist – General Supervision level applies if PT not certified

Credentialed by AAET: R. NCS.T, State Licensed Physical Therapist with ABPTS certification or Qualified Physical Therapist or ABEM: CNCT

95938

21

Board Certified* Neurologist or Physiatrist

Credentialed by ABRET: R. EP T. or R. EEG T. or State Licensed Qualified Physical Therapist or ABPTS Physical Therapist

95939

21

Board Certified* Neurologist or Physiatrist

Credentialed by ABRET: R. EP T. or R. EEG T. or State Licensed Qualified Physical Therapist or ABPTS Physical Therapist

95954

03

Board Certified* Neurologist

Credentialed by ABRET: R. EEG T

95957

01

Board Certified* Neurologist

Credentialed by ABRET: R. EEG T

95958

03

Board Certified* Neurologist

Credentialed by ABRET: R. EEG T

96105

04

Board Certified* Psychiatrist, Clinical Psychologist or Qualified Independent Psychologist

Physician Service Code – must be performed by a physician

96110

04

Board Certified* Psychiatrist, Clinical Psychologist or Qualified Independent Psychologist

Physician Service Code – must be performed by a physician

96112

04

Board Certified* Psychiatrist, Clinical Psychologist or Qualified Independent Psychologist

Physician Service Code – must be performed by a physician or other qualified health care professional

96113

04

Board Certified* Psychiatrist, Clinical Psychologist or Qualified Independent Psychologist

Physician Service Code – must be performed by a physician or other qualified health care professional

96116

04

Board Certified* Psychiatrist, Clinical Psychologist or Qualified Independent Psychologist

Physician Service Code – must be performed by a physician or other qualified health care professional

96121

04

Board Certified* Psychiatrist, Clinical Psychologist or Qualified Independent Psychologist

Physician Service Code – must be performed by a physician or other qualified health care professional

96130

04

Board Certified* Psychiatrist, Clinical Psychologist or Qualified Independent Psychologist

Physician Service Code – must be performed by a physician or other qualified health care professional

96131

04

Board Certified* Psychiatrist, Clinical Psychologist or Qualified Independent Psychologist

Physician Service Code – must be performed by a physician or other qualified health care professional

96132

04

Board Certified* Psychiatrist, Clinical Psychologist or Qualified Independent Psychologist

Physician Service Code – must be performed by a physician or other qualified health care professional

96133

04

Board Certified* Psychiatrist, Clinical Psychologist or Qualified Independent Psychologist

Physician Service Code – must be performed by a physician or other qualified health care professional

96136

04

Board Certified* Psychiatrist, Clinical Psychologist or Qualified Independent Psychologist

Physician Service Code – must be performed by a physician or other qualified health care professional

96137

04

Board Certified* Psychiatrist, Clinical Psychologist or Qualified Independent Psychologist

Physician Service Code – must be performed by a physician or other qualified health care professional

96138

04

Board Certified* Psychiatrist, Clinical Psychologist or Qualified Independent Psychologist

Physician Service Code – must be performed by a physician or other qualified health care professional

96139

04

Board Certified* Psychiatrist, Clinical Psychologist or Qualified Independent Psychologist

Physician Service Code – must be performed by a physician or other qualified health care professional

96146

04

Board Certified* Psychiatrist, Clinical Psychologist or Qualified Independent Psychologist

Physician Service Code – must be performed by a physician or other qualified health care professional

0509T

01

Board Certified* Ophthalmologist, Neurologist or Optometrist

Credentialed by JCAHPO: COT or COMT

0554T

09

Board Certified* Radiologist or Urologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

0555T

09

Board Certified* Radiologist or Urologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

0556T

09

Board Certified* Radiologist or Urologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

0557T

09

Board Certified* Radiologist or Urologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

0558T

09

Board Certified* Radiologist or Urologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT

0604T

09

Board Certified* Ophthalmologist or Optometrist

N/A

0605T

09

Board Certified* Ophthalmologist or Optometrist

N/A

0606T

09

Board Certified* Ophthalmologist or Optometrist

N/A

0607T

09

Board Certified* Cardiologist

State Licensed RN or Paramedic or Credentialed by NHA: CET or CCI: CCT or CRAT

0608T

09

Board Certified* Cardiologist

State Licensed RN or Paramedic or Credentialed by NHA: CET or CCI: CCT or CRAT

0609T

09

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: MR or ARMRIT: MRI

0610T

09

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: MR or ARMRIT: MRI

0611T

09

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: MR or ARMRIT: MRI

0612T

09

Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification

Credentialed by ARRT: MR or ARMRIT: MRI

0615T

09

Board Certified* Neurologist

N/A

0648T

09

Board Certified* Radiologist, Gastroenterologist or Hepatologist

Credentialed by ARRT: MR or ARMRIT: MRI

0649T

09

Board Certified* Radiologist, Gastroenterologist or Hepatologist

Credentialed by ARRT: MR or ARMRIT: MRI

0683T

02

Board Certified* Cardiologist

State Licensed: RN or Paramedic or Credentialed by CCI: CCT or NHA: CET

0685T

02

Board Certified* Cardiologist

State Licensed: RN or Paramedic or Credentialed by CCI: CCT or NHA: CET

0689T

01

Board Certified* Radiologist

Credentialed by ARDMS: RDMS or ARRT: R.T.-S

0690T

01

Board Certified* Radiologist

Credentialed by ARDMS: RDMS or ARRT: R.T.-S

0694T

01

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R

0696T

09

Board Certified* Cardiologist

State Licensed: RN or Paramedic or Credentialed by CCI: CCT or NHA: CET

0697T

02

Board Certified* Radiologist, Gastroenterologist or Hepatologist

Credentialed by ARRT: MR or ARMRIT: MRI

0698T

02

Board Certified* Radiologist, Gastroenterologist or Hepatologist

Credentialed by ARRT: MR or ARMRIT: MRI

0723T

09

Board Certified* Radiologist, Gastroenterologist or Hepatologist

Credentialed by ARRT: MR or ARMRIT: MRI

0724T

09

Board Certified* Radiologist, Gastroenterologist or Hepatologist

Credentialed by ARRT: MR or ARMRIT: MRI

0742T

01

Board Certified* Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT: N or NMTCB: CNMT

0764T

09

Board Certified* Internist or Cardiologist

RN, LPN/LVN or State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

0765T

09

Board Certified* Internist or Cardiologist

RN, LPN/LVN or State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

0779T

09

Board Certified* Gastroenterologist

RN

0804T

09

Board Certified* Cardiologist

RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET

G0106

03

Board Certified* Gastroenterologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-N or NMTCB: CNMT

G0130

01

Board Certified* Radiologist or Orthopaedic Surgeon

State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-BD

G0235

01

Board Certified* Nuclear Medicine or Radiology

State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-N or NMTCB: CNMT

G0248

01

Board Certified* Cardiologist

RN

G0249

01

Board Certified* Cardiologist

Demonstrates Proficiency

G0279

09

Board Certified* Radiologist

State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-M

G0398

09

Physician Certified by ABSM or ABMS: Sleep Medicine OR ABFM, ABIM, ABOHNS, ABPN or AOA: Sleep Medicine Subspecialty Certification

Credentialed by BRPT: RPSGT or CPSGT, ABRET: R. EEG T. (Polysomnography) or NBRC: CRT, SDS or RRT

G0399

09

Physician Certified by ABSM or ABMS: Sleep Medicine OR ABFM, ABIM, ABOHNS, ABPN or AOA: Sleep Medicine Subspecialty Certification

Credentialed by BRPT: RPSGT or CPSGT, ABRET: R. EEG T. (Polysomnography) or NBRC: CRT, SDS or RRT

G0400

09

Physician Certified by ABSM or ABMS: Sleep Medicine OR ABFM, ABIM, ABOHNS, ABPN or AOA: Sleep Medicine Subspecialty Certification

Credentialed by BRPT: RPSGT or CPSGT, ABRET: R. EEG T. (Polysomnography) or NBRC: CRT, SDS or RRT

Q0035

01

Board Certified* Cardiologist

Credentialed by CCI: CCT, NHA: CET, State Licensed Paramedic or RN


*Note: The CPT/HCPCS codes that have “Licensed Audiologist” designated with an asterisk in the “Technician Qualification Requirements” column would not be subject to direct supervision of a physician. Licensed Audiologist designated with an asterisk are for CPT/HCPCS codes included on the CMS Audiology Code List (revised CY2023). As defined in the Social Security Act, section 1861(ll) (3), the term “audiology services” specifically means such hearing and balance assessment services furnished by a qualified audiologist as the audiologist is legally authorized to perform under State law (or the State regulatory mechanism provided by State law), as would otherwise be covered if furnished by a physician. Additional information on Audiology Services and the CMS Audiology Code List may be found on the CMS website at https://www.cms.gov/Medicare/Medicare-Fee-For-Service-Payment/PhysicianFeeSched/audiology.html

Note: The technical component (TC) of services represented by CPT codes 95925-95927 and 95938-95939 may be performed by an appropriately certified PT. However, in an IDTF supervision by the appropriate physician(s) is required for global and professional component (PC) billing.

Please refer to A56773, Billing and Coding: Neurophysiology Evoked Potentials for additional information on CPT codes 92651-92653, 95925-95930, 95938 and 95939.

Note: Board Certified* Nuclear Medicine meets the supervising physician and interpreting physician qualification requirements for the tests 93015, 93016, 93017, and 93018 when performed in conjunction with myocardial perfusion and cardiac blood pool imaging studies. In this situation, a Certified Nuclear Medicine Technologist (ARRT: N or NMTCB: CNMT) meets the technician qualification requirements for 93015, 93016, and 93017 when performed under direct supervision of a Board Certified* Nuclear Medicine physician.

Note: Nonphysician practitioners such as nurse practitioners (NPs), clinical nurse specialists (CNSs) and physician assistants (PAs) who personally perform diagnostic psychological and neuropsychological tests are excluded from having to perform these tests under the general supervision of a physician or a clinical psychologist (CP). Rather, NPs and CNSs must perform such tests under the requirements of their respective benefit instead of the requirements for diagnostic psychological and neuropsychological tests. Accordingly, NPs and CNSs must perform tests in collaboration (as defined under Medicare law at section 1861(aa)(6) of the Act) with a physician. PAs perform tests under the general supervision of a physician as required for services furnished under the PA benefit. (Reference CMS IOM Pub. 100-02, Chapter 15, Section 80.2)

Key for IDTF Table Abbreviations

American Association of Electrodiagnostic Technologists (AAET)

http://www.aaet.info

Registered Nerve Conduction Study Technologist (R.NCS.T.)

American Board of Electrodiagnostic Medicine (ABEM)

http://www.abemexam.org/

Certified Nerve Conduction Technologist (CNCT)

American Board of Family Medicine (ABFM)

http://www.theabfm.org

ABFM: Sleep Medicine Subspecialty Certification

American Board of Internal Medicine (ABIM)

https://www.abim.org/certification/policies/internal-medicine-subspecialty-policies/sleep-medicine

ABIM: Sleep Medicine Subspecialty Certification

American Board of Nuclear Medicine (ABNM)

http://www.abnm.org

American Board of Otolaryngology - Head and Neck Surgery (ABOHNS)

https://www.abohns.org/

ABOHNS: Sleep Medicine Subspecialty Certification

American Board of Psychiatry and Neurology (ABPN)

http://www.abpn.com

ABPN: Sleep Medicine Subspecialty Certification

American Board of Medical Specialties (ABMS)

http://www.abms.or

American Board of Physical Therapy Specialties (ABPTS)

https://specialization.apta.org

ABPTS Physical Therapist

American Board of Registration of Electroencephalographic and Evoked Potential Technologists (ABRET)

http://www.abret.org/exam_info/eligibility.php

Registered Electroencephalographic technologist (R. EEG T.)

Registered Evoked Potential Technologist (R. EP T.)

American Board of Sleep Medicine (ABSM)

www.absm.org

American Osteopathic Association (AOA)

https://osteopathic.org

AOA Doctor of Osteopathic Medicine (D.O.)

American Registry of Diagnostic Medical Sonographers (ARDMS

http://www.ardms.org

Registered Diagnostic Cardiac Sonographer (RDCS)

Registered Diagnostic Medical Sonographer (RDMS)

Registered Vascular Technologist (RVT)

American Registry of Magnetic Resonance Imaging Technologists (ARMRIT)

http://www.armrit.org/

Certified Magnetic Resonance Imaging Technologist

American Society of Neuroimaging (ASN)

http://www.asnweb.org/

ASN: Neuroimaging Subspecialty Certification

The American Registry of Radiologic Technologists (ARRT)

https://www.medical-professionals.com/en/arrt-certification-guide

Certified Magnetic Resonance Imaging Technologist (ARRT: MR) Certified and Registered Technologist -Bone Densitometry (R.T-BD) Certified and Registered Technologist-Breast Sonography (R.T.-BS

Certified and Registered Technologist – Cardiac Interventional Radiography (ARRT: CI Certified and Registered Technologist -Computed Tomography [R.T.-CT])

Certified and Registered Technologist -Magnetic Resonance Imaging (R.T.-MR) Certified and Registered Technologist-Mammography (R.T.-M)

Certified and Registered Technologist-Nuclear Medicine Technology (R.T.-N)

Certified and Registered Technologist-Radiography (R.T.-R)

Certified and Registered Technologist –Sonography (R.T.-S)

Certified and Registered Technologist –Vascular Sonography (R.T.-VS)

The Board of Certification of the Ophthalmic Photographers’ Society

https://mail.opsweb.org/Certif/Certif.html

Certified Retinal Angiographer (CRA)

Board of Registered Polysomnographic Technologists (BRPT)

http://www.brpt.org/

Registered Polysomnographic Technologist (RPSGT)

Certified Polysomnographic Technician (CPSGT)

Cardiovascular Credentialing International (CCI)

http://www.cci-online.org/

Certified Cardiographic Technician (CCT)

Registered Cardiac Sonographer (RCS)

Registered Cardiovascular Invasive Specialist (RCIS)

Registered Vascular Specialist (RVS)

Certified Rhythm Analysis Technician (CRAT)

The International Society for Clinical Densitometry (ISCD)

http://www.iscd.org/

Certified Bone Densitometry Technologist (CBDT)

Joint Commission on Allied Health Personnel in Ophthalmology (JCAHPO)

http://www.jcahpo.org/newsite/certificationhome.htm

JCAHPO offers three levels of certification:

Certified Ophthalmic Assistant (COA)

Certified Ophthalmic Technician (COT) (Intermediate Level)

Certified Ophthalmic Medical Technologist (COMT) (Advanced Level)

National Board for Respiratory Care (NBRC)

http://www.nbrc.org

Certified Pulmonary Function Technologist (CPFT)

Registered Pulmonary Function Technologist (RPFT)

Certified Respiratory Therapist (CRT)

Sleep Disorder Specialist (SDS)

Registered Respiratory Therapist (RRT)

National Healthcareer Association (NHA)

https://www.nhanow.com/

Certified EKG Technician (CET)

Nuclear Medicine Technology Certification Board (NMTCB)

http://www.nmtcb.org/

Certified Nuclear Medicine Technologist (CNMT)

United Council for Neurologic Subspecialties (UCNS)

http://www.ucns.org/

UCNS: Neuroimaging Subspecialty Certification

Response To Comments

Number Comment Response
1
N/A

Coding Information

Bill Type Codes

Code Description
999x Not Applicable
N/A

Revenue Codes

Code Description
99999 Not Applicable
N/A

CPT/HCPCS Codes

Expand All | Collapse All

Group 1

(974 Codes)
Group 1 Paragraph

Note: Providers are reminded to refer to the long descriptors of the CPT codes in their CPT book.

 Group 1 Codes
Code Description
10005 Fna bx w/us gdn 1st les
10006 Fna bx w/us gdn ea addl
10007 Fna bx w/fluor gdn 1st les
10008 Fna bx w/fluor gdn ea addl
10009 Fna bx w/ct gdn 1st les
10010 Fna bx w/ct gdn ea addl
10011 Fna bx w/mr gdn 1st les
10012 Fna bx w/mr gdn ea addl
10021 Fna bx w/o img gdn 1st les
19000 Puncture aspir cyst breast
19001 Puncture aspir cyst brst ea
19081 Bx breast 1st lesion strtctc
19082 Bx breast add lesion strtctc
19083 Bx breast 1st lesion us imag
19084 Bx breast add lesion us imag
19085 Bx breast 1st lesion mr imag
19086 Bx breast add lesion mr imag
19281 Perq device breast 1st imag
19283 Perq dev breast 1st strtctc
19285 Perq dev breast 1st us imag
20501 Inject sinus tract for x-ray
23350 Injection for shoulder x-ray
24220 Injection px for elbow arthg
25246 Injection for wrist x-ray
27093 Injection for hip x-ray
27095 Injection for hip x-ray
27369 Njx cntrst kne arthg/ct/mri
27648 Injection for ankle x-ray
36901 Intro cath dialysis circuit
42550 Injection for salivary x-ray
43754 Dx gastr intub w/asp spec
43755 Dx gastr intub w/asp specs
47531 Injection for cholangiogram
47532 Injection for cholangiogram
47544 Removal duct glbldr calculi
51600 Injection for bladder x-ray
51610 Injection for bladder x-ray
51725 Simple cystometrogram
51726 Complex cystometrogram
51727 Cystometrogram w/up
51728 Cystometrogram w/vp
51729 Cystometrogram w/vp&up
51736 Urine flow measurement
51741 Electro-uroflowmetry first
51784 Anal/urinary muscle study
51785 Anal/urinary muscle study
51792 Urinary reflex study
51797 Intraabdominal pressure test
51798 Us urine capacity measure
54240 Penis study
54250 Penis study
58340 Catheter for hysterography
59025 Fetal non-stress test
62284 Injection for myelogram
62302 Myelography lumbar injection
62303 Myelography lumbar injection
62304 Myelography lumbar injection
62305 Myelography lumbar injection
70010 Contrast x-ray of brain
70015 Contrast x-ray of brain
70030 X-ray eye for foreign body
70100 X-ray exam of jaw <4views
70110 X-ray exam of jaw 4/> views
70120 X-ray exam of mastoids
70130 X-ray exam of mastoids
70134 X-ray exam of middle ear
70140 X-ray exam of facial bones
70150 X-ray exam of facial bones
70160 X-ray exam of nasal bones
70170 X-ray exam of tear duct
70190 X-ray exam of eye sockets
70200 X-ray exam of eye sockets
70210 X-ray exam of sinuses
70220 X-ray exam of sinuses
70240 X-ray exam pituitary saddle
70250 X-ray exam of skull
70260 X-ray exam of skull
70300 X-ray exam of teeth
70310 X-ray exam of teeth
70320 Full mouth x-ray of teeth
70328 X-ray exam of jaw joint
70330 X-ray exam of jaw joints
70332 X-ray exam of jaw joint
70336 Magnetic image jaw joint
70350 X-ray head for orthodontia
70355 Panoramic x-ray of jaws
70360 X-ray exam of neck
70370 Throat x-ray & fluoroscopy
70371 Speech evaluation complex
70380 X-ray exam of salivary gland
70390 X-ray exam of salivary duct
70450 Ct head/brain w/o dye
70460 Ct head/brain w/dye
70470 Ct head/brain w/o & w/dye
70480 Ct orbit/ear/fossa w/o dye
70481 Ct orbit/ear/fossa w/dye
70482 Ct orbit/ear/fossa w/o&w/dye
70486 Ct maxillofacial w/o dye
70487 Ct maxillofacial w/dye
70488 Ct maxillofacial w/o & w/dye
70490 Ct soft tissue neck w/o dye
70491 Ct soft tissue neck w/dye
70492 Ct sft tsue nck w/o & w/dye
70496 Ct angiography head
70498 Ct angiography neck
70540 Mri orbit/face/neck w/o dye
70542 Mri orbit/face/neck w/dye
70543 Mri orbt/fac/nck w/o &w/dye
70544 Mr angiography head w/o dye
70545 Mr angiography head w/dye
70546 Mr angiograph head w/o&w/dye
70547 Mr angiography neck w/o dye
70548 Mr angiography neck w/dye
70549 Mr angiograph neck w/o&w/dye
70551 Mri brain stem w/o dye
70552 Mri brain stem w/dye
70553 Mri brain stem w/o & w/dye
70554 Fmri brain by tech
70555 Fmri brain by phys/psych
71045 X-ray exam chest 1 view
71046 X-ray exam chest 2 views
71047 X-ray exam chest 3 views
71048 X-ray exam chest 4+ views
71100 X-ray exam ribs uni 2 views
71101 X-ray exam unilat ribs/chest
71110 X-ray exam ribs bil 3 views
71111 X-ray exam ribs/chest4/> vws
71120 X-ray exam breastbone 2/>vws
71130 X-ray strenoclavic jt 3/>vws
71250 Ct thorax dx c-
71260 Ct thorax dx c+
71270 Ct thorax dx c-/c+
71271 Ct thorax lung cancer scr c-
71275 Ct angiography chest
71550 Mri chest w/o dye
71551 Mri chest w/dye
71552 Mri chest w/o & w/dye
71555 Mri angio chest w or w/o dye
72020 X-ray exam of spine 1 view
72040 X-ray exam neck spine 2-3 vw
72050 X-ray exam neck spine 4/5vws
72052 X-ray exam neck spine 6/>vws
72070 X-ray exam thorac spine 2vws
72072 X-ray exam thorac spine 3vws
72074 X-ray exam thorac spine4/>vw
72080 X-ray exam thoracolmb 2/> vw
72081 X-ray exam entire spi 1 vw
72082 X-ray exam entire spi 2/3 vw
72083 X-ray exam entire spi 4/5 vw
72084 X-ray exam entire spi 6/> vw
72100 X-ray exam l-s spine 2/3 vws
72110 X-ray exam l-2 spine 4/>vws
72114 X-ray exam l-s spine bending
72120 X-ray bend only l-s spine
72125 Ct neck spine w/o dye
72126 Ct neck spine w/dye
72127 Ct neck spine w/o & w/dye
72128 Ct chest spine w/o dye
72129 Ct chest spine w/dye
72130 Ct chest spine w/o & w/dye
72131 Ct lumbar spine w/o dye
72132 Ct lumbar spine w/dye
72133 Ct lumbar spine w/o & w/dye
72141 Mri neck spine w/o dye
72142 Mri neck spine w/dye
72146 Mri chest spine w/o dye
72147 Mri chest spine w/dye
72148 Mri lumbar spine w/o dye
72149 Mri lumbar spine w/dye
72156 Mri neck spine w/o & w/dye
72157 Mri chest spine w/o & w/dye
72158 Mri lumbar spine w/o & w/dye
72159 Mr angio spine w/o&w/dye
72170 X-ray exam of pelvis
72190 X-ray exam of pelvis
72191 Ct angiograph pelv w/o&w/dye
72192 Ct pelvis w/o dye
72193 Ct pelvis w/dye
72194 Ct pelvis w/o & w/dye
72195 Mri pelvis w/o dye
72196 Mri pelvis w/dye
72197 Mri pelvis w/o & w/dye
72198 Mr angio pelvis w/o & w/dye
72200 X-ray exam si joints
72202 X-ray exam si joints 3/> vws
72220 X-ray exam sacrum tailbone
72240 Myelography neck spine
72255 Myelography thoracic spine
72265 Myelography l-s spine
72270 Myelogphy 2/> spine regions
72285 Discography cerv/thor spine
72295 X-ray of lower spine disk
73000 X-ray exam of collar bone
73010 X-ray exam of shoulder blade
73020 X-ray exam of shoulder
73030 X-ray exam of shoulder
73040 Contrast x-ray of shoulder
73050 X-ray exam of shoulders
73060 X-ray exam of humerus
73070 X-ray exam of elbow
73080 X-ray exam of elbow
73085 Contrast x-ray of elbow
73090 X-ray exam of forearm
73092 X-ray exam of arm infant
73100 X-ray exam of wrist
73110 X-ray exam of wrist
73115 Contrast x-ray of wrist
73120 X-ray exam of hand
73130 X-ray exam of hand
73140 X-ray exam of finger(s)
73200 Ct upper extremity w/o dye
73201 Ct upper extremity w/dye
73202 Ct uppr extremity w/o&w/dye
73206 Ct angio upr extrm w/o&w/dye
73218 Mri upper extremity w/o dye
73219 Mri upper extremity w/dye
73220 Mri uppr extremity w/o&w/dye
73221 Mri joint upr extrem w/o dye
73222 Mri joint upr extrem w/dye
73223 Mri joint upr extr w/o&w/dye
73225 Mr angio upr extr w/o&w/dye
73501 X-ray exam hip uni 1 view
73502 X-ray exam hip uni 2-3 views
73503 X-ray exam hip uni 4/> views
73521 X-ray exam hips bi 2 views
73522 X-ray exam hips bi 3-4 views
73523 X-ray exam hips bi 5/> views
73525 Contrast x-ray of hip
73551 X-ray exam of femur 1
73552 X-ray exam of femur 2/>
73560 X-ray exam of knee 1 or 2
73562 X-ray exam of knee 3
73564 X-ray exam knee 4 or more
73565 X-ray exam of knees
73580 Contrast x-ray of knee joint
73590 X-ray exam of lower leg
73592 X-ray exam of leg infant
73600 X-ray exam of ankle
73610 X-ray exam of ankle
73615 Contrast x-ray of ankle
73620 X-ray exam of foot
73630 X-ray exam of foot
73650 X-ray exam of heel
73660 X-ray exam of toe(s)
73700 Ct lower extremity w/o dye
73701 Ct lower extremity w/dye
73702 Ct lwr extremity w/o&w/dye
73706 Ct angio lwr extr w/o&w/dye
73718 Mri lower extremity w/o dye
73719 Mri lower extremity w/dye
73720 Mri lwr extremity w/o&w/dye
73721 Mri jnt of lwr extre w/o dye
73722 Mri joint of lwr extr w/dye
73723 Mri joint lwr extr w/o&w/dye
73725 Mr ang lwr ext w or w/o dye
74018 X-ray exam abdomen 1 view
74019 X-ray exam abdomen 2 views
74021 X-ray exam abdomen 3+ views
74022 X-ray exam complete abdomen
74150 Ct abdomen w/o dye
74160 Ct abdomen w/dye
74170 Ct abdomen w/o & w/dye
74174 Ct angio abd&pelv w/o&w/dye
74175 Ct angio abdom w/o & w/dye
74176 Ct abd & pelvis w/o contrast
74177 Ct abd & pelv w/contrast
74178 Ct abd & pelv 1/> regns
74181 Mri abdomen w/o dye
74182 Mri abdomen w/dye
74183 Mri abdomen w/o & w/dye
74185 Mri angio abdom w orw/o dye
74190 X-ray exam of peritoneum
74210 X-ray xm phrnx&/crv esoph c+
74220 X-ray xm esophagus 1cntrst
74221 X-ray xm esophagus 2cntrst
74230 X-ray xm swlng funcj c+
74240 X-ray xm upr gi trc 1cntrst
74246 X-ray xm upr gi trc 2cntrst
74248 X-ray sm int f-thru std
74250 X-ray xm sm int 1cntrst std
74251 X-ray xm sm int 2cntrst std
74261 Ct colonography dx
74262 Ct colonography dx w/dye
74270 X-ray xm colon 1cntrst std
74280 X-ray xm colon 2cntrst std
74290 Contrast x-ray gallbladder
74300 X-ray bile ducts/pancreas
74301 X-rays at surgery add-on
74328 X-ray bile duct endoscopy
74329 X-ray for pancreas endoscopy
74330 X-ray bile/panc endoscopy
74400 Urography iv +-kub tomog
74410 Urography nfs drip&/bolus
74415 Urography nfs drip&/bls w/nf
74420 Urography rtrgr +-kub
74425 Urography antegrade rs&i
74430 Contrast x-ray bladder
74440 X-ray male genital tract
74445 X-ray exam of penis
74450 X-ray urethra/bladder
74455 X-ray urethra/bladder
74470 X-ray exam of kidney lesion
74712 Mri fetal sngl/1st gestation
74713 Mri fetal ea addl gestation
74740 X-ray female genital tract
74742 X-ray fallopian tube
74775 X-ray exam of perineum
75557 Cardiac mri for morph
75559 Cardiac mri w/stress img
75561 Cardiac mri for morph w/dye
75563 Card mri w/stress img & dye
75565 Card mri veloc flow mapping
75571 Ct hrt w/o dye w/ca test
75572 Ct hrt w/3d image
75573 Ct hrt c+ strux cgen hrt ds
75574 Ct angio hrt w/3d image
75580 N-invas est c ffr sw aly cta
75600 Contrast exam thoracic aorta
75605 Contrast exam thoracic aorta
75625 Contrast exam abdominl aorta
75630 X-ray aorta leg arteries
75635 Ct angio abdominal arteries
75705 Artery x-rays spine
75710 Artery x-rays arm/leg
75716 Artery x-rays arms/legs
75726 Artery x-rays abdomen
75731 Artery x-rays adrenal gland
75733 Artery x-rays adrenals
75736 Artery x-rays pelvis
75741 Artery x-rays lung
75743 Artery x-rays lungs
75746 Artery x-rays lung
75756 Artery x-rays chest
75774 Artery x-ray each vessel
75801 Lymph vessel x-ray arm/leg
75803 Lymph vessel x-ray arms/legs
75805 Lymph vessel x-ray trunk
75807 Lymph vessel x-ray trunk
75809 Nonvascular shunt x-ray
75810 Vein x-ray spleen/liver
75820 Vein x-ray arm/leg
75822 Vein x-ray arms/legs
75825 Vein x-ray trunk
75827 Vein x-ray chest
75831 Vein x-ray kidney
75833 Vein x-ray kidneys
75840 Vein x-ray adrenal gland
75842 Vein x-ray adrenal glands
75860 Vein x-ray neck
75870 Vein x-ray skull
75872 Vein x-ray skull epidural
75880 Vein x-ray eye socket
75885 Vein x-ray liver w/hemodynam
75887 Vein x-ray liver w/o hemodyn
75889 Vein x-ray liver w/hemodynam
75891 Vein x-ray liver
76000 Fluoroscopy <1 hr phys/qhp
76010 X-ray nose to rectum
76080 X-ray exam of fistula
76098 X-ray exam surgical specimen
76100 X-ray exam of body section
76120 Cine/video x-rays
76125 Cine/video x-rays add-on
76376 3d render w/intrp postproces
76377 3d render w/intrp postproces
76380 Cat scan follow-up study
76390 Mr spectroscopy
76391 Mr elastography
76506 Echo exam of head
76510 Oph us dx b-scan&quan a-scan
76511 Oph us dx quan a-scan only
76512 Oph us dx b-scan
76513 Oph us dx ant sgm us uni/bi
76514 Echo exam of eye thickness
76516 Echo exam of eye
76519 Echo exam of eye
76529 Echo exam of eye
76536 Us exam of head and neck
76604 Us exam chest
76641 Ultrasound breast complete
76642 Ultrasound breast limited
76700 Us exam abdom complete
76705 Echo exam of abdomen
76706 Us abdl aorta screen aaa
76770 Us exam abdo back wall comp
76775 Us exam abdo back wall lim
76776 Us exam k transpl w/doppler
76801 Ob us < 14 wks single fetus
76802 Ob us < 14 wks addl fetus
76805 Ob us >= 14 wks sngl fetus
76810 Ob us >= 14 wks addl fetus
76811 Ob us detailed sngl fetus
76812 Ob us detailed addl fetus
76813 Ob us nuchal meas 1 gest
76814 Ob us nuchal meas add-on
76815 Ob us limited fetus(s)
76816 Ob us follow-up per fetus
76817 Transvaginal us obstetric
76818 Fetal biophys profile w/nst
76819 Fetal biophys profil w/o nst
76820 Umbilical artery echo
76821 Middle cerebral artery echo
76825 Echo exam of fetal heart
76826 Echo exam of fetal heart
76827 Echo exam of fetal heart
76828 Echo exam of fetal heart
76830 Transvaginal us non-ob
76831 Echo exam uterus
76856 Us exam pelvic complete
76857 Us exam pelvic limited
76870 Us exam scrotum
76872 Us transrectal
76873 Echograp trans r pros study
76881 Us compl joint r-t w/img
76882 Us lmtd jt/fcl evl nvasc xtr
76883 Us nrv&acc strux 1xtr compre
76885 Us exam infant hips dynamic
76886 Us exam infant hips static
76942 Echo guide for biopsy
76946 Echo guide for amniocentesis
76975 Gi endoscopic ultrasound
76977 Us bone density measure
76978 Us trgt dyn mbubb 1st les
76979 Us trgt dyn mbubb ea addl
77002 Needle localization by xray
77003 Fluoroguide for spine inject
77012 Ct scan for needle biopsy
77014 Ct scan for therapy guide
77021 Mri guidance ndl plmt rs&i
77046 Mri breast c- unilateral
77047 Mri breast c- bilateral
77048 Mri breast c-+ w/cad uni
77049 Mri breast c-+ w/cad bi
77053 X-ray of mammary duct
77054 X-ray of mammary ducts
77063 Breast tomosynthesis bi
77065 Dx mammo incl cad uni
77066 Dx mammo incl cad bi
77067 Scr mammo bi incl cad
77071 X-ray stress view
77072 X-rays for bone age
77073 X-rays bone length studies
77074 X-rays bone survey limited
77075 X-rays bone survey complete
77076 X-rays bone survey infant
77077 Joint survey single view
77078 Ct bone density axial
77080 Dxa bone density axial
77081 Dxa bone density/peripheral
77084 Magnetic image bone marrow
77085 Dxa bone density study
77086 Fracture assessment via dxa
77417 Radiology port images(s)
78012 Thyroid uptake measurement
78013 Thyroid imaging w/blood flow
78014 Thyroid imaging w/blood flow
78015 Thyroid met imaging
78016 Thyroid met imaging/studies
78018 Thyroid met imaging body
78020 Thyroid met uptake
78070 Parathyroid planar imaging
78071 Parathyrd planar w/wo subtrj
78072 Parathyrd planar w/spect&ct
78075 Adrenal cortex & medulla img
78102 Bone marrow imaging ltd
78103 Bone marrow imaging mult
78104 Bone marrow imaging body
78110 Plasma volume single
78111 Plasma volume multiple
78120 Red cell mass single
78121 Red cell mass multiple
78122 Blood volume
78130 Red cell survival study
78140 Red cell sequestration
78185 Spleen imaging
78191 Platelet survival
78195 Lymph system imaging
78201 Liver imaging
78202 Liver imaging with flow
78215 Liver and spleen imaging
78216 Liver & spleen image/flow
78226 Hepatobiliary system imaging
78227 Hepatobil syst image w/drug
78230 Salivary gland imaging
78231 Serial salivary imaging
78232 Salivary gland function exam
78258 Esophageal motility study
78261 Gastric mucosa imaging
78262 Gastroesophageal reflux exam
78264 Gastric emptying imag study
78265 Gastric emptying imag study
78266 Gastric emptying imag study
78267 Breath tst attain/anal c-14
78268 Breath test analysis c-14
78278 Acute gi blood loss imaging
78282 Gi protein loss exam
78290 Meckels divert exam
78291 Leveen/shunt patency exam
78300 Bone imaging limited area
78305 Bone imaging multiple areas
78306 Bone imaging whole body
78315 Bone imaging 3 phase
78350 Bone mineral single photon
78414 Non-imaging heart function
78428 Cardiac shunt imaging
78429 Myocrd img pet 1 std w/ct
78430 Myocrd img pet rst/strs w/ct
78431 Myocrd img pet rst&strs ct
78432 Myocrd img pet 2rtracer
78433 Myocrd img pet 2rtracer ct
78434 Aqmbf pet rest & rx stress
78445 Vascular flow imaging
78451 Ht muscle image spect sing
78452 Ht muscle image spect mult
78453 Ht muscle image planar sing
78454 Ht musc image planar mult
78456 Acute venous thrombus image
78457 Venous thrombosis imaging
78458 Ven thrombosis images bilat
78459 Myocrd img pet single study
78466 Heart infarct image
78468 Heart infarct image (ef)
78469 Heart infarct image (3d)
78472 Gated heart planar single
78473 Gated heart multiple
78481 Heart first pass single
78483 Heart first pass multiple
78491 Myocrd img pet 1std rst/strs
78492 Myocrd img pet mlt rst&strs
78494 Heart image spect
78496 Heart first pass add-on
78579 Lung ventilation imaging
78580 Lung perfusion imaging
78582 Lung ventilat&perfus imaging
78597 Lung perfusion differential
78598 Lung perf&ventilat diferentl
78600 Brain image < 4 views
78601 Brain image w/flow < 4 views
78605 Brain image 4+ views
78606 Brain image w/flow 4 + views
78608 Brain imaging (pet)
78610 Brain flow imaging only
78630 Cerebrospinal fluid scan
78635 Csf ventriculography
78645 Csf shunt evaluation
78650 Csf leakage imaging
78660 Nuclear exam of tear flow
78700 Kidney imaging morphol
78701 Kidney imaging with flow
78707 K flow/funct image w/o drug
78708 K flow/funct image w/drug
78709 K flow/funct image multiple
78725 Kidney function study
78730 Urinary bladder retention
78740 Ureteral reflux study
78761 Testicular imaging w/flow
78800 Rp loclzj tum 1 area 1 d img
78801 Rp loclzj tum 2+area 1+d img
78802 Rp loclzj tum whbdy 1 d img
78803 Rp loclzj tum spect 1 area
78804 Rp loclzj tum whbdy 2+d img
78811 Pet image ltd area
78812 Pet image skull-thigh
78813 Pet image full body
78814 Pet image w/ct lmtd
78815 Pet image w/ct skull-thigh
78816 Pet image w/ct full body
78830 Rp loclzj tum spect w/ct 1
78831 Rp loclzj tum spect 2 areas
78832 Rp loclzj tum spect w/ct 2
78835 Rp quan meas single area
86485 Skin test candida
86490 Coccidioidomycosis skin test
86580 Tb intradermal test
91010 Esophagus motility study
91020 Gastric motility studies
91022 Duodenal motility study
91030 Acid perfusion of esophagus
91034 Gastroesophageal reflux test
91035 G-esoph reflx tst w/electrod
91037 Esoph imped function test
91038 Esoph imped funct test > 1hr
91040 Esoph balloon distension tst
91065 Breath hydrogen/methane test
91110 Gi trc img intral esoph-ile
91111 Gi trc img intral esophagus
91113 Gi trc img intral colon i&r
91120 Rectal sensation test
91122 Anal pressure record
91132 Electrogastrography
91133 Electrogastrography w/test
92025 Cptrized corneal topography
92060 Sensorimotor examination
92081 Limited visual field xm
92082 Intermediate visual field xm
92083 Extended visual field xm
92100 Serial tonometry
92132 Cmptr ophth dx img ant segmt
92133 Cmptr ophth img optic nerve
92134 Cptr ophth dx img post segmt
92136 Ophthalmic biometry
92229 Img rta detc/mntr ds poc aly
92230 Fluorescein angioscopy i&r
92235 Fluorescein angrph mltiframe
92240 Icg angiography i&r uni/bi
92242 Fluorescein&icg angiography
92250 Fundus photography w/i&r
92265 Ndl oculoelectromyography 1+
92270 Electro-oculography w/i&r
92273 Full field erg w/i&r
92274 Multifocal erg w/i&r
92283 Extnd color vision xm
92284 Dx dark adaptation exam i&r
92285 External ocular photography
92286 Ant sgm img i&r speclr mic
92511 Nasopharyngoscopy
92517 Vemp test i&r cervical
92518 Vemp test i&r ocular
92519 Vemp tst i&r cervical&ocular
92537 Caloric vstblr test w/rec
92538 Caloric vstblr test w/rec
92540 Basic vestibular evaluation
92541 Spontaneous nystagmus test
92542 Positional nystagmus test
92544 Optokinetic nystagmus test
92545 Oscillating tracking test
92546 Sinusoidal rotational test
92547 Supplemental electrical test
92548 Cdp-sot 6 cond w/i&r
92549 Cdp-sot 6 cond w/i&r mct&adt
92550 Tympanometry & reflex thresh
92552 Pure tone audiometry air
92553 Audiometry air & bone
92555 Speech threshold audiometry
92556 Speech audiometry complete
92557 Comprehensive hearing test
92562 Loudness balance test
92563 Tone decay hearing test
92565 Stenger test pure tone
92567 Tympanometry
92568 Acoustic refl threshold tst
92570 Acoustic immitance testing
92571 Filtered speech hearing test
92572 Staggered spondaic word test
92575 Sensorineural acuity test
92576 Synthetic sentence test
92577 Stenger test speech
92579 Visual audiometry (vra)
92582 Conditioning play audiometry
92583 Select picture audiometry
92584 Electrocochleography
92587 Evoked auditory test limited
92588 Evoked auditory tst complete
92596 Ear protector evaluation
92597 Oral speech device eval
92601 Cochlear implt f/up exam <7
92602 Reprogram cochlear implt <7
92603 Cochlear implt f/up exam 7/>
92604 Reprogram cochlear implt 7/>
92611 Motion fluoroscopy/swallow
92620 Auditory function 60 min
92621 Auditory function + 15 min
92625 Tinnitus assessment
92651 Aep hearing status deter i&r
92652 Aep thrshld est mlt freq i&r
92653 Aep neurodiagnostic i&r
93000 Electrocardiogram complete
93005 Electrocardiogram tracing
93010 Electrocardiogram report
93015 Cardiovascular stress test
93016 Cardiovascular stress test
93017 Cardiovascular stress test
93018 Cardiovascular stress test
93024 Cardiac drug stress test
93025 Microvolt t-wave assess
93040 Rhythm ecg with report
93041 Rhythm ecg tracing
93042 Rhythm ecg report
93224 Ecg monit/reprt up to 48 hrs
93225 Ecg monit/reprt up to 48 hrs
93226 Ecg monit/reprt up to 48 hrs
93227 Ecg monit/reprt up to 48 hrs
93228 Remote 30 day ecg rev/report
93229 Remote 30 day ecg tech supp
93241 Ext ecg>48hr<7d rec scan a/r
93242 Ext ecg>48hr<7d recording
93243 Ext ecg>48hr<7d scan a/r
93244 Ext ecg>48hr<7d rev&interpj
93245 Ext ecg>7d<15d rec scan a/r
93246 Ext ecg>7d<15d recording
93247 Ext ecg>7d<15d scan a/r
93248 Ext ecg>7d<15d rev&interpj
93260 Prgrmg dev eval impltbl sys
93261 Interrogate subq defib
93268 Ecg record/review
93270 Remote 30 day ecg rev/report
93271 Ecg/monitoring and analysis
93272 Ecg/review interpret only
93278 Ecg/signal-averaged
93279 Prgrmg dev eval pm/ldls pm
93280 Pm device progr eval dual
93281 Pm device progr eval multi
93282 Prgrmg eval implantable dfb
93283 Prgrmg eval implantable dfb
93284 Prgrmg eval implantable dfb
93285 Prgrmg dev eval scrms ip
93286 Peri-px eval pm/ldls pm ip
93287 Peri-px device eval & prgr
93288 Interrog evl pm/ldls pm ip
93289 Interrog device eval heart
93290 Interrog dev eval icpms ip
93291 Interrog dev eval scrms ip
93292 Wcd device interrogate
93293 Pm phone r-strip device eval
93294 Rem interrog evl pm/ldls pm
93295 Dev interrog remote 1/2/mlt
93296 Rem interrog evl pm/ids
93297 Rem interrog dev eval icpms
93298 Rem interrog dev eval scrms
93303 Echo transthoracic
93304 Echo transthoracic
93306 Tte w/doppler complete
93307 Tte w/o doppler complete
93308 Tte f-up or lmtd
93312 Echo transesophageal
93313 Echo transesophageal
93314 Echo transesophageal
93315 Echo transesophageal
93316 Echo transesophageal
93317 Echo transesophageal
93319 3d echo img cgen car anomal
93320 Doppler echo exam heart
93321 Doppler echo exam heart
93325 Doppler color flow add-on
93350 Stress tte only
93351 Stress tte complete
93352 Admin ecg contrast agent
93451 Right heart cath
93452 Left hrt cath w/ventrclgrphy
93453 R&l hrt cath w/ventriclgrphy
93454 Coronary artery angio s&i
93455 Coronary art/grft angio s&i
93456 R hrt coronary artery angio
93457 R hrt art/grft angio
93458 L hrt artery/ventricle angio
93459 L hrt art/grft angio
93460 R&l hrt art/ventricle angio
93461 R&l hrt art/ventricle angio
93571 Heart flow reserve measure
93572 Heart flow reserve measure
93584 Vngrph chd anom/persist svc
93585 Vngrph chd azygs/hemiazygs
93586 Vngrph chd coronary sinus
93587 Vngrph chd vnvn cltrl at/abv
93588 Vngrph chd vnvn cltrl below
93593 R hrt cath chd nml nt cnj
93594 R hrt cath chd abnl nt cnj
93595 L hrt cath chd nm/abn nt cnj
93596 R&l hrt cath chd nml nt cnj
93597 R&l hrt cath chd abnl nt cnj
93598 Car outp meas drg cath chd
93660 Tilt table evaluation
93701 Bioimpedance cv analysis
93740 Temperature gradient studies
93770 Measure venous pressure
93784 Ambl bp mntr w/software
93786 Ambl bp mntr w/sw rec only
93788 Ambl bp mntr w/sw a/r
93790 Ambl bp mntr w/sw i&r
93792 Pt/caregiver traing home inr
93880 Extracranial bilat study
93882 Extracranial uni/ltd study
93886 Intracranial complete study
93888 Intracranial limited study
93890 Tcd vasoreactivity study
93892 Tcd emboli detect w/o inj
93893 Tcd emboli detect w/inj
93922 Upr/l xtremity art 2 levels
93923 Upr/lxtr art stdy 3+ lvls
93924 Lwr xtr vasc stdy bilat
93925 Lower extremity study
93926 Lower extremity study
93930 Upper extremity study
93931 Upper extremity study
93970 Extremity study
93971 Extremity study
93975 Vascular study
93976 Vascular study
93978 Vascular study
93979 Vascular study
93980 Penile vascular study
93981 Penile vascular study
93985 Dup-scan hemo compl bi std
93986 Dup-scan hemo compl uni std
93990 Doppler flow testing
94010 Breathing capacity test
94014 Patient recorded spirometry
94015 Patient recorded spirometry
94016 Review patient spirometry
94060 Evaluation of wheezing
94070 Evaluation of wheezing
94150 Vital capacity test
94200 Lung function test (mbc/mvv)
94375 Respiratory flow volume loop
94450 Hypoxia response curve
94452 Hast w/report
94453 Hast w/oxygen titrate
94617 Exercise tst brncspsm w/ecg
94618 Pulmonary stress testing
94619 Exercise tst brncspsm wo ecg
94621 Cardiopulm exercise testing
94664 Evaluate pt use of inhaler
94680 Exhaled air analysis o2
94681 Exhaled air analysis o2/co2
94690 Exhaled air analysis
94726 Pulm funct tst plethysmograp
94727 Pulm function test by gas
94728 Airwy resist by oscillometry
94729 Co/membane diffuse capacity
94760 Measure blood oxygen level
94761 Measure blood oxygen level
94762 Measure blood oxygen level
94772 Breath recording infant
94774 Ped home apnea rec compl
94775 Ped home apnea rec hk-up
94776 Ped home apnea rec downld
94777 Ped home apnea rec report
95004 Percut allergy skin tests
95024 Iq tests w/allergenic xtrc
95027 Icut allergy titrate-airborn
95028 Icut allergy test-delayed
95044 Allergy patch tests
95052 Photo patch test
95056 Photosensitivity tests
95060 Eye allergy tests
95065 Nose allergy test
95070 Bronchial allergy tests
95700 Eeg cont rec w/vid eeg tech
95705 Eeg w/o vid 2-12 hr unmntr
95706 Eeg wo vid 2-12hr intmt mntr
95707 Eeg w/o vid 2-12hr cont mntr
95708 Eeg wo vid ea 12-26hr unmntr
95709 Eeg w/o vid ea 12-26hr intmt
95710 Eeg w/o vid ea 12-26hr cont
95711 Veeg 2-12 hr unmonitored
95712 Veeg 2-12 hr intmt mntr
95713 Veeg 2-12 hr cont mntr
95714 Veeg ea 12-26 hr unmntr
95715 Veeg ea 12-26hr intmt mntr
95716 Veeg ea 12-26hr cont mntr
95717 Eeg phys/qhp 2-12 hr w/o vid
95718 Eeg phys/qhp 2-12 hr w/veeg
95719 Eeg phys/qhp ea incr w/o vid
95720 Eeg phy/qhp ea incr w/veeg
95721 Eeg phy/qhp>36<60 hr w/o vid
95722 Eeg phy/qhp>36<60 hr w/veeg
95723 Eeg phy/qhp>60<84 hr w/o vid
95724 Eeg phy/qhp>60<84 hr w/veeg
95725 Eeg phy/qhp>84 hr w/o vid
95726 Eeg phy/qhp>84 hr w/veeg
95782 Polysom <6 yrs 4/> paramtrs
95783 Polysom <6 yrs cpap/bilvl
95800 Slp stdy unattended
95801 Slp stdy unatnd w/anal
95805 Multiple sleep latency test
95806 Sleep study unatt&resp efft
95807 Sleep study attended
95808 Polysom any age 1-3> param
95810 Polysom 6/> yrs 4/> param
95811 Polysom 6/>yrs cpap 4/> parm
95812 Eeg 41-60 minutes
95813 Eeg extnd mntr 61-119 min
95816 Eeg awake and drowsy
95819 Eeg awake and asleep
95822 Eeg coma or sleep only
95824 Eeg cerebral death only
95830 Insert electrodes for eeg
95860 Muscle test one limb
95861 Muscle test 2 limbs
95863 Muscle test 3 limbs
95864 Muscle test 4 limbs
95867 Muscle test cran nerv unilat
95868 Muscle test cran nerve bilat
95869 Muscle test thor paraspinal
95870 Muscle test nonparaspinal
95872 Muscle test one fiber
95875 Limb exercise test
95885 Musc tst done w/nerv tst lim
95886 Musc test done w/n test comp
95887 Musc tst done w/n tst nonext
95905 Motor &/ sens nrve cndj test
95907 Nvr cndj tst 1-2 studies
95908 Nrv cndj tst 3-4 studies
95909 Nrv cndj tst 5-6 studies
95910 Nrv cndj test 7-8 studies
95911 Nrv cndj test 9-10 studies
95912 Nrv cndj test 11-12 studies
95913 Nrv cndj test 13/> studies
95919 Quan puplmtry phy/qhp uni/bi
95921 Autonomic nrv parasym inervj
95922 Autonomic nrv adrenrg inervj
95923 Autonomic nrv syst funj test
95924 Ans parasymp & symp w/tilt
95925 Somatosensory testing
95926 Somatosensory testing
95927 Somatosensory testing
95928 C motor evoked uppr limbs
95929 C motor evoked lwr limbs
95930 Visual ep test cns w/i&r
95933 Blink reflex test
95937 Neuromuscular junction test
95938 Somatosensory testing
95939 C motor evoked upr&lwr limbs
95954 Eeg monitoring/giving drugs
95957 Eeg digital analysis
95958 Eeg monitoring/function test
96105 Assessment of aphasia
96110 Developmental screen w/score
96112 Devel tst phys/qhp 1st hr
96113 Devel tst phys/qhp ea addl
96116 Nubhvl xm phys/qhp 1st hr
96121 Nubhvl xm phy/qhp ea addl hr
96130 Psycl tst eval phys/qhp 1st
96131 Psycl tst eval phys/qhp ea
96132 Nrpsyc tst eval phys/qhp 1st
96133 Nrpsyc tst eval phys/qhp ea
96136 Psycl/nrpsyc tst phy/qhp 1st
96137 Psycl/nrpsyc tst phy/qhp ea
96138 Psycl/nrpsyc tech 1st
96139 Psycl/nrpsyc tst tech ea
96146 Psycl/nrpsyc tst auto result
G0106 Colon ca screen;barium enema
G0130 Single energy x-ray study
G0235 Pet not otherwise specified
G0248 Demonstrate use home inr mon
G0249 Provide inr test mater/equip
G0279 Tomosynthesis, mammo
G0398 Home sleep test/type 2 porta
G0399 Home sleep test/type 3 porta
G0400 Home sleep test/type 4 porta
Q0035 Cardiokymography
0509T Pattern erg w/i&r
0554T B1 str & fx rsk analysis
0555T B1 str&fx rsk transmis data
0556T B1 str & fx rsk assessment
0557T B1 str & fx rsk i&r
0558T Ct scan f/biomchn ct alys
0604T Rem oct rta dev setup&educaj
0605T Rem oct rta techl sprt min 8
0606T Rem oct rta phys/qhp ea 30d
0607T Rem mntr pulm flu mntr setup
0608T Rem mntr pulm flu mntr alys
0609T Mrs disc pain acquisj data
0610T Mrs disc pain transmis data
0611T Mrs disc pain alg alys data
0612T Mrs discogenic pain i&r
0615T Eye mvmt alys w/o calbrj i&r
0648T Quan mr tis wo mri 1orgn
0649T Quan mr tiss w/mri 1orgn
0683T Prgrmg dev eval isdss ip
0685T Interrog dev eval isdss ip
0689T Quan us tis charac w/o dx us
0690T Quan us tis charac w/dx us
0694T 3d vol img&rcnstj brst/ax
0696T Bdy surf mapg pm/cvdfb f/up
0697T Quan mr tis wo mri mlt orgn
0698T Quan mr tiss w/mri mlt orgn
0723T Qmrcp w/o dx mri sm anat ses
0724T Qmrcp w/dx mri same anatomy
0742T Aqmbf spect xers/strs & rest
0764T Asstv alg ecg rsk asmt cncrt
0765T Asstv alg ecg rsk asmt prev
0779T Gi myoelectrical actv study
0804T Prgrmg evl ldls pm 2chmbr ip

Group 2

(85 Codes)
Group 2 Paragraph

The following HCPCS codes are covered additional services considered necessary to perform diagnostic testing in an IDTF.

Note: Positron emission tomography (PET) Radiopharmaceutical/Tracer codes A9597 or A9598 should only be used when there is no existing dedicated PET tracer code available (reference Medicare Claims Processing Manual, Chapter 13, Section 60.3.2)). For additional information, please refer to A53134 NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions.

Note: Effective for claims with dates of service on or after 12/15/2017, HCPCS code A9580 (NaF-18) is nationally non-covered and all associated NaF-18 PET related coding including PET scan CPT codes are also non-covered.

 Group 2 Codes
Code Description
36415 Routine venipuncture
A4648 Implantable tissue marker
A9500 Tc99m sestamibi
A9501 Technetium tc-99m teboroxime
A9502 Tc99m tetrofosmin
A9503 Tc99m medronate
A9504 Tc99m apcitide
A9505 Tl201 thallium
A9507 In111 capromab
A9508 I131 iodobenguate, dx
A9509 Iodine i-123 sod iodide mil
A9510 Tc99m disofenin
A9512 Tc99m pertechnetate
A9515 Choline c-11
A9516 Iodine i-123 sod iodide mic
A9521 Tc99m exametazime
A9526 Nitrogen n-13 ammonia
A9528 Iodine i-131 iodide cap, dx
A9537 Tc99m mebrofenin
A9539 Tc99m pentetate
A9540 Tc99m maa
A9541 Tc99m sulfur colloid
A9547 In111 oxyquinoline
A9548 In111 pentetate
A9550 Tc99m gluceptate
A9551 Tc99m succimer
A9552 F18 fdg
A9555 Rb82 rubidium
A9556 Ga67 gallium
A9558 Xe133 xenon 10mci
A9560 Tc99m labeled rbc
A9561 Tc99m oxidronate
A9562 Tc99m mertiatide
A9567 Technetium tc-99m aerosol
A9569 Technetium tc-99m auto wbc
A9570 Indium in-111 auto wbc
A9571 Indium in-111 auto platelet
A9572 Indium in-111 pentetreotide
A9573 Inj, gadopiclenol, 1 ml
A9575 Inj gadoterate meglumi 0.1ml
A9576 Inj prohance multipack
A9577 Inj multihance
A9578 Inj multihance multipack
A9579 Gad-base mr contrast nos,1ml
A9581 Gadoxetate disodium inj
A9583 Gadofosveset trisodium inj
A9584 Iodine i-123 ioflupane
A9585 Gadobutrol injection
A9586 Florbetapir f18
A9587 Gallium ga-68
A9588 Fluciclovine f-18
A9591 Fluoroestradiol f 18
A9592 Copper cu 64 dotatate diag
A9593 Gallium ga-68 psma-11 ucsf
A9594 Gallium ga-68 psma-11, ucla
A9595 Piflu f-18, dia 1 millicurie
A9596 Gallium illuccix 1 millicure
A9597 Pet, dx, for tumor id, noc
A9598 Pet dx for non-tumor id, noc
A9601 Flortaucipir inj 1 millicuri
A9602 Fluorodopa f-18 diag per mci
A9608 Flotufolastat f18 diag 1 mci
A9609 F18 fdg, 15 millicuries
A9800 Gallium locametz 1 millicuri
J1200 Diphenhydramine hcl injectio
J1245 Dipyridamole injection
J1250 Inj dobutamine hcl/250 mg
J1610 Glucagon hydrochloride/1 mg
J1611 Inj glucagon hcl, fresenius
J1940 Furosemide injection
J2250 Inj midazolam hydrochloride
J2765 Metoclopramide hcl injection
J2785 Regadenoson injection
Q9950 Inj sulf hexa lipid microsph
Q9951 Locm >= 400 mg/ml iodine,1ml
Q9953 Inj fe-based mr contrast,1ml
Q9954 Oral mr contrast, 100 ml
Q9955 Inj perflexane lip micros,ml
Q9956 Inj octafluoropropane mic,ml
Q9957 Inj perflutren lip micros,ml
Q9965 Locm 100-199mg/ml iodine,1ml
Q9966 Locm 200-299mg/ml iodine,1ml
Q9967 Locm 300-399mg/ml iodine,1ml
Q9982 Flutemetamol f18 diagnostic
Q9983 Florbetaben f18 diagnostic
N/A

CPT/HCPCS Modifiers

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Group 1

Group 1 Paragraph

N/A

 Group 1 Codes

N/A

N/A

ICD-10-CM Codes that Support Medical Necessity

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Group 1

(1 Code)
Group 1 Paragraph

It is the provider’s responsibility to select codes carried out to the highest level of specificity and selected from the ICD-10-CM code book appropriate to the year in which the service is rendered for the claim(s) submitted.

 Group 1 Codes
Code Description
XX000 Not Applicable
N/A

ICD-10-CM Codes that DO NOT Support Medical Necessity

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Group 1

(1 Code)
Group 1 Paragraph

N/A

 Group 1 Codes
Code Description
XX000 Not Applicable
N/A

ICD-10-PCS Codes

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Group 1

Group 1 Paragraph

N/A

 Group 1 Codes

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Additional ICD-10 Information

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Bill Type Codes

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.

Code Description
999x Not Applicable
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Revenue Codes

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.

Code Description
99999 Not Applicable
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Other Coding Information

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Group 1

Group 1 Paragraph

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 Group 1 Codes

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Coding Table Information

Excluded CPT/HCPCS Codes - Table Format
Code Descriptor Generic Name Descriptor Brand Name Exclusion Effective Date Exclusion End Date Reason for Exclusion
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Non-Excluded CPT/HCPCS Ended Codes - Table Format
Code Descriptor Generic Name Descriptor Brand Name Exclusion Effective Date Exclusion End Date Reason for Exclusion
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Revision History Information

Revision History Date Revision History Number Revision History Explanation
04/01/2024 R43

Article revised and published on 04/04/2024. The following CPT codes have been added to the ‘Credentialing Matrix’ with applicable levels of physician supervision and technician requirements: 19000, 19001, 19281, 19283, 19285, 36901, 47531, 47532, 47544, 74712, 74713, and G0235. Within the ‘Credentialing Matrix’ the physician supervision requirements have been updated for the following codes: 76881 and 76882 requires level 09, 95806 requires level 01. The following code has been added to Group 2 CPT/HCPCS codes: A4648. In response to the April Quarterly CPT/HCPCS Update, the following codes have been deleted from Group 2 CPT/HCPCS codes: J1020, J1030, and J1040.

Additionally, the article text has been revised to include billing and coding information from the LCD as the LCD is being retired. This information includes updated IOM and CFR references, physician requirements, and additional services/supplies. 
01/01/2024 R42

Article revised and published on 01/25/2024 effective for dates of service on and after 01/01/2024 to reflect the Annual HCPCS/CPT Code Updates. The following CPT codes have been added to the ‘Credentialing Matrix’ with applicable levels of physician supervision and supervising physician and technician qualification requirements, and to the CPT/HCPCS Group 1 Codes: 75580, 93584, 93585, 93586, 93587 and 93588. The following HCPCS codes have been added to the CPT/HCPCS Group 2 Codes: A9608 and A9609.

The following CPT/HCPCS codes have been deleted and therefore have been removed from the article: 74710, 0501T, 0502T, 0503T, 0504T, 0508T and G2066.

For the following CPT/HCPCS codes either the short description and/or the long description was changed. Depending on which description is used in this article, there may not be any change in how the code displays: 92025, 92060, 92081, 92082, 92083, 92100, 92230, 92235, 92240, 92242, 92250, 92265, 92270, 92283, 92285, 92286, 93241, 93242, 93243, 93244, 93245, 93246, 93247, 93248 (CPT/HCPCS Group 1 Codes).

The article has also been revised in response to an inquiry. The following statement has been added at the bottom of the ‘Physician Supervision of Diagnostic Procedures’ section: “The provider is responsible for adhering to applicable CMS regulations for diagnostic test supervision.”
10/01/2023 R41

Article revised and published on 10/05/2023 effective for dates of service on and after 10/01/2023 to reflect the October Quarterly CPT/HCPCS Update. The following HCPCS code has been added to the article: A9573 in Group 2 Codes.
07/20/2023 R40

Article revised and published on 07/20/2023 effective for dates of service on and after 07/20/2023 in response to an inquiry. The ‘Credentialing Matrix’ section has been revised to add the following statements: “The following table reflects CMS supervision requirements, which describes the levels of physician supervision required for furnishing the technical component of diagnostic tests for Medicare beneficiaries who are not a hospital inpatient or outpatient.”

*American Board of Medical Specialty (ABMS), American Board of Nuclear Medicine (ABNM), American Board of Physical Medicine and Rehabilitation (ABPMR), American Board of Psychiatry and Neurology (ABPN), American Osteopathic Association (AOA), or subspecialty certification.” (An asterisk is used in place of the acronyms within the credential matrix).

The following section was added under ‘Coding Guidance’: ‘JW and JZ Modifiers’.

The ‘Documentation Requirements’ section was revised to add additional information regarding documentation to be maintained by the IDTF. The ‘Key for IDTF Table Abbreviations’ has been updated for relevant websites and to add AAET: R.NCS.T., ABPTS Physical Therapist, BRPT: CPSGT and CCI: CRAT.

The ‘Technician Qualification Requirements’ in the ‘Credentialing Matrix’ have been revised to change ‘State License: General Radiographer’ and ‘CRT-R’ to ‘State License: General Radiographer or Credentialed by ARRT: Radiography (R.T.-R)’. The ‘Technician Qualification Requirements’ have also been revised for the following CPT/HCPCS Codes: 19081, 19082, 19083, 19084, 19085, 19086, 27369, 72194, 76706, 93015, 93016, 93017, 93229, 93241, 93242, 93243, 95782, 95783, 95800, 95801, 95805, 95806, 95807, 95808, 95810, 95811, 95925-95927, 95938-95939, 0508T, 0607T-0608T, G0398, G0399, G0400 and G2066.

The ‘Supervising Physician Qualification Requirements’ in the ‘Credentialing Matrix’ have been revised to change ‘Board Certified (ABMS)’ to ‘Board Certified*’. The ‘Supervising Physician Qualification Requirements’ have been revised for the following CPT/HCPCS Codes: 27369, 95782, 95783, 95800, 95801, 95805, 95806, 95807, 95808, 95810, 95811, 0508T, G0398, G0399 and G0400.

In response to the July Quarterly HCPCS/CPT Code Updates, the following code has been added to the ‘Credentialing Matrix’ with applicable levels of physician supervision and supervising physician and technician qualification requirements, and to the ‘CPT/HCPCS Codes’ section for ‘Group 1 Codes’: 0804T which became effective on 07/01/2023. Minor formatting changes have been made throughout the article.
01/01/2023 R39

Article revised and published on 01/26/2023 effective for dates of service on and after 01/01/2023 to reflect the Annual HCPCS/CPT Code Updates. The following CPT codes have been added to the ‘Credentialing Matrix’ with applicable levels of physician supervision and supervising physician and technician qualification requirements, and to the ‘CPT/HCPCS Codes’ section for ‘Group 1 Codes’: 76883, 95919, 0742T, 0764T, 0765T and 0779T. The following HCPCS code has been added to the 'CPT/HCPCS Codes' section for 'Group 2 Codes': J1611. For the following CPT codes either the short description and/or the long description was changed. Depending on which description is used in this article, there may not be any change in how the code displays: 24220, 76882, 78803, 78830, 78831, 78832, 92229 and 92284 in Group 1 Codes.
12/08/2022 R38

Article revised and published on 12/08/2022 in response to inquiries. The ‘Supervising Physician Qualification Requirements’ in the ‘Credentialing Matrix’ have been revised for CPT codes 27648, 76881 and 76882 to add ‘Board Certified Podiatrist’. CPT codes 0723T and 0724T have been added to the ‘Credentialing Matrix’ with Physician Supervision Level of 9, Supervising Physician Qualification Requirements – Board Certified Radiologist, Gastroenterologist or Hepatologist and Technician Qualification Requirements - ARRT: MR or ARMRIT: MRI. CPT codes 0723T and 0724T have also been added to the ‘CPT/HCPCS Codes’ for ‘Group 1 Codes’.
10/01/2022 R37

Article revised and published on 10/13/2022 effective for dates of service on and after 10/01/2022 to reflect the October Quarterly CPT/HCPCS Code Updates. The following HCPCS codes have been added to the ‘CPT/HCPCS Codes’ section for ‘Group 2’ codes: A9602 and A9800.

Please note that Revision History R36 below should read as:

Article revised and published on 9/29/2022. The following CPT/HCPCS codes have been added to the ‘Credentialing Matrix’ with applicable levels of physician supervision and supervising physician and technician qualification requirements, as well as to the CPT/HCPCS ‘Group 1 Codes:’ 0501T, 0502T, 0503T, and 0504T.
09/29/2022 R36

Article revised and published on 9/29/2022 effective for dates of service on and after 9/29/2022. The following CPT/HCPCS codes have been added to the ‘Credentialing Matrix’ with applicable levels of physician supervision and supervising physician and technician qualification requirements, as well as to the CPT/HCPCS ‘Group 1 Codes:’ 95800, 95801, 95806, 0501T, 0502T, 0503T, and 0504T.
07/01/2022 R35

Article revised and published on 08/04/2022 effective for dates of service on and after 07/01/2022 to reflect the July Quarterly CPT/HCPCS Code Update and in response to an inquiry.

The following HCPCS codes have been added to the ‘CPT/HCPCS Codes’ section for ‘Group 2’ codes: A9596 and A9601. Reference to Article A53132 for PET Scans Used for Oncologic Conditions has been removed from ‘Group 2 Paragraph’ as this Article has been retired.
01/01/2022 R34

Article revised and published on 01/20/2022 effective for dates of service on and after 01/01/2022 to reflect the Annual HCPCS/CPT Code Updates. The following CPT codes have been added to the ‘Credentialing Matrix’ with applicable levels of physician supervision and supervising physician and technician qualification requirements, and to the ‘CPT/HCPCS Codes’ section for ‘Group 1 Codes’: 0683T, 0685T, 0689T, 0690T, 0694T, 0696T, 0697T, 0698T, 91113, 93319, 93593, 93594, 93595, 93596, 93597 and 93598. The following HCPCS code has been added to the 'CPT/HCPCS Codes' section for 'Group 2 Codes': A9595. The following CPT codes have been deleted and therefore have been removed from the ‘Credentialing Matrix’ section and the ‘CPT/HCPCS Codes’ section for ‘Group 1 Codes’: 72275, 76101, 76102, 92561, 92564, 93530, 93531, 93532, 93533, 93561, 93562 and 95943. For the following CPT codes either the short description and/or the long description was changed. Depending on which description is used in this article, there may not be any change in how the code displays: 0648T, 0649T, 75573, 91110, 91111 and 95070 in the 'CPT/HCPCS Codes' section for 'Group 1 Codes'.

Additionally, in response to inquiries, the following CPT codes have been added to the ‘Credentialing Matrix’ with applicable levels of physician supervision and supervising physician and technician qualification requirements, and to the ‘CPT/HCPCS Codes’ section for ‘Group 1 Codes’: 75571 and 92229. The ‘Key for IDTF Table Abbreviations’ has also been revised to add National Healthcareer Association (NHA): Certified EKG Technician (CET) and the ‘Credentialing Matrix’ has been revised accordingly for applicable procedures.
11/11/2021 R33

Article revised and published on 11/11/2021 in response to inquiries to add CPT codes 71271 and 76391 to the ‘Credentialing Matrix’ with applicable levels of physician supervision and supervising physician and technician qualification requirements, and to add these CPT codes to the ‘CPT/HCPCS Codes’ section for ‘Group 1 Codes’.
09/09/2021 R32

Article revised and published on 09/09/2021 in response to an inquiry to add CPT codes 0648T and 0649T to the ‘Credentialing Matrix’ with applicable levels of physician supervision and supervising physician and technician qualification requirements, and to add these CPT codes to the ‘CPT/HCPCS Codes’ section for ‘Group 1 Codes’. Minor formatting changes have also been made.
07/01/2021 R31

Article revised and published on 8/12/2021 effective for dates of service on and after 7/1/2021 to reflect the Quarterly CPT/HCPCS updates.

The following HCPCS codes have been added to the Article: A9593 and A9594 in Group 2.
04/01/2021 R30

Article revised and published on 6/10/2021 effective for dates of service on and after 4/1/2021 to reflect a response to an inquiry. The following HCPCS code has been added to the 'CPT/HCPCS Codes/Group 2 Codes': A9592.
04/01/2021 R29

Article revised and published on 4/1/2021 effective for dates of service on and after 4/1/021. The “Interpreting Physician” and the contractors requirements for qualifications have been removed from the Credentialing Matrix table and “Interpreting Physician” requirements in response to an inquiry.

The following CPT Codes have had supervisory changes in response to the annual update: 78265, 78266, 78267, 78268, 78459, 86485, 92611, 93740, 93770, 94774, 94775, 94776, 94777, 0554T, 0555T, 0556T, 0557T, 0558T, G0398, G0399, and G0400.
01/01/2021 R28

Article revised and published on 03/11/2021 effective for dates of service on and after 01/01/2021 in response to an inquiry to add HCPCS code A9591 to the ‘Group 2 Codes’ in the ‘CPT/HCPCS Codes’ section. A reference listed under the ‘Internet-Only Manuals (IOMs)’ for ‘CMS IOM Publication 100-08, Medicare Program Integrity Manual’ was revised from: ‘Chapter 15, Section 15.5.19.3 Interpreting Physicians’ to: ‘Chapter 10, Section 10.2.2, I. Independent Diagnostic Testing Facilities (IDTFs), 8. Interpreting Physicians’.
01/01/2021 R27

Article revised and published on 02/11/2021 effective for dates of service on and after 01/01/2021 to reflect the Annual 2021 HCPCS/CPT Code Updates.

CPT codes 92517, 92518, 92519, 92651, 92652, 92653, 93241, 93242, 93243, 93244, 93245, 93246, 93247, 93248 and 94619 were added to the “Credentialing Matrix” table and the “CPT/HCPCS Codes/Group 1 codes:” sections of this billing and coding article.

Also, CPT codes 76970, 78135, 92585, 92586, 94250, 94400, 94750, 94770, 95071, 0295T, 0296T, 0297T and 0298T were deleted from the “Credentialing Matrix” table and the “CPT/HCPCS Codes/Group 1 codes:” sections of this billing and coding article.

In addition, Descriptors were revised for CPT codes 71250, 71260, 71270, 74425, 76513, 78130, 94617 and 95070. Depending on which description is used in this article, there may not be any change in how the code displays in the “CPT/HCPCS Codes/Group 1 codes:” section of this billing and coding article. Minor typographical corrections and formatting changes made throughout the coding section and the IOM section was updated.

Additionally, consistent with CR 11700 and 11917, the IOM Publication 100-08 was updated.
09/24/2020 R26

Article revised and published on 09/24/2020 effective for dates of service on and after 09/24/2020. Based on an inquiry, the following CPT codes have been added to the Credentialing Matrix with applicable level of physician supervision, supervising physician and interpreting physician qualification requirements, and technician qualification requirements and to also add these codes to the CPT code Group 1 Codes: 10005, 10006, 10007, 10008, 10009, 10010, 10011, 10012, and 10021.
07/01/2020 R25

Article revised and published on 07/30/2020 effective for dates of service on and after 07/01/2020 to reflect the July 2020 HCPCS Update to add the following CPT codes to the Credentialing Matrix with applicable level of physician supervision, supervising physician and interpreting physician qualification requirements, and technician qualification requirements and to also add these codes to the CPT code Group 1 Codes: 0604T, 0605T, 0606T, 0607T, 0608T, 0609T, 0610T, 0611T, 0612T, and 0615T.
05/14/2020 R24

Article revised and published on 05/14/2020. CPT codes 19081-19086 have been added to the credentialing table and CPT code group 1. The title, Licensed Vocational Nurse (LVN) has been added and placed with Licensed Practical Nurse (LPN). Some formatting changes have also been made throughout the document.
01/01/2020 R23

Article revised and published on 01/16/2020 effective for dates of service on and after 01/01/2020 to reflect the annual CPT/HCPCS code updates. The following CPT/HCPCS code(s) have been added to the article: 74221, 74248, 78429, 78430, 78431, 78432, 78433, 78434, 78830, 78831, 78832, 78835, 92549, 93985, 93986, 95700, 95705, 95706, 95707, 95708, 95709, 95710, 95711, 95712, 95713, 95714, 95715, 95716, 95717, 95718, 95719, 95720, 95721, 95722, 95723, 95724, 95725, 95726 and G2066. The following CPT/HCPCS code(s) have been deleted and therefore removed from the article: 74241, 74245, 74247, 74249, 74260, 78205, 78206, 78320, 78607, 78647, 78710, 78805, 78806, 78807, 93299, 95827, 95950, 95951, 95953, 95956 and G0365. For the following CPT/HCPCS code(s) either the short description and/or the long description has been changed. Depending on which description is used in this article, there may not be any change in how the code displays in the document: 74022, 74210, 74220, 74240, 74246, 74250, 74251, 74270, 74280, 76805, 76810, 78491, 78492, 78800, 78801, 78802, 78803, 78804, 92548, 93784, 93786, 93788, 93790, 93792, 94060, 94728, 95813, 0554T, 0555T, 0556T and 0557T.
09/26/2019 R22

Article revised and published on 09/26/2019. CPT codes 0554T, 0555T, 0556T, 0557T and 0558T, which became effective 07/01/2019, have been added to the credentialing matrix and group 1 codes in response to CR 11392.

Also, due to system changes, the coding section of this article has been reorganized and a new section for modifiers has been added.
07/11/2019 R21

Article revised and published on 07/11/2019. In response to CR 11134, which constitutes a maintenance update specific to NCDs, CPT code 0508T has been added to CPT Code Group 1 and to the Credentialing Matrix as follows: Supervising Physician - Board Certified (ABMS) Radiologist, Technician Requirement - General Radiographer Credentialed by ARRT and Supervision level - 1. Information listed in the Physician Supervision of Diagnostic Procedures section has been placed in table format.
05/30/2019 R20

Article revised and published on 05/30/2019 to indicate an error in Revision History Number 19 (R19) below. The wrong LCD number (L35084) was listed in R19. The second sentence in R19 should read: All codes from L35448-Independent Diagnostic Testing Facility (IDTF) have been placed in this article per CMS Change Request 10901.
01/01/2019 R19

Article revised and published on 02/28/2019. All codes from L35084-Independent Diagnostic Testing Facility (IDTF) have been placed in this article per CMS Change Request 10901. Effective for dates of service on and after 01/01/2019 the following CPT/HCPCS codes have been added to the CPT/HCPCS Code Group 1 and the Credentialing Matrix with a level of physician supervision 04; supervising physician and interpreting physician qualification requirements of Psychiatrist, Clinical Psychologist or Qualified Independent Psychologist; and technician qualification requirements of Physician Service Code – must be performed by a physician of other qualified health care professional: 96138, 96139 and 96146.
01/01/2019 R18

Article revised and published on 02/14/2019. Effective for dates of service on and after 01/01/2019 to reflect the annual CPT/HCPCS code updates, the following CPT/HCPCS code(s) have been added to the Credentialing Matrix: 27369, 76978, 76979, 77046, 77047, 77048, 77049, 92273, 92274, 0509T, 96112, 96113, 96121, 96130, 96131, 96132, 96133, 96136, and 96137. The following CPT/HCPCS code(s) have been deleted and therefore removed from the article: 27370, 76001, 77058, 77059, 78270, 78271, 78272, 92275, 96101, 96102, 96103, 96111, 96118, 96119, 96120, and 0159T. For the following CPT/HCPCS code(s) either the short description and/or the long description has been changed: 77021, 93279, 93285, 93286, 93288, 93290, 93291, 93294, 93296, 93297, 93298, 93299, and 96116.

Added notation underneath the credentialing matrix regarding supervision exclusion and Medicare laws for nonphysician practitioners who personally perform diagnostic psychological and neuropsychological tests.

Updated the level of physician supervision on the credentialing matrix for several CPT/HCPCS codes per the 2019 CMS Physician Fee Schedule.
09/13/2018 R17

Article revised and published on 09/13/2018. The credentialing matrix level of physician supervision for CPT codes 76813 and 76814 have been revised from "03" (personal) to "01" (general) supervision (reference 2018 CMS Physician Fee schedule).
03/08/2018 R16

Article revised and published on 03/08/2018. The credentialing matrix has been revised to add Board Certified (ABMS or ABNM) Nuclear Medicine* to the supervising physician and interpreting physician qualification requirements for the CPT codes 93015, 93016, 93017, and 93018 when performed in conjunction with myocardial perfusion and cardiac blood pool imaging studies. Added ARRT: N or NMTCB: CNMT* to the technician qualification requirements for 93015, 93016, and 93017 when performed under direct supervision of a Board Certified (ABMS or ABNM) Nuclear Medicine physician. An asterisk note was added beneath the credentialing matrix table to clarify the intent of these additions.

Per annual review, updated the CMS IOM citations within the article text section.
01/01/2018 R15

Article revised and published on 01/25/2018. Effective for dates of service on and after 01/01/2018 to reflect the annual CPT/HCPCS code updates, the following CPT/HCPCS code(s) have been added to the Credentialing Matrix: 71045, 71046, 71047, 71048, 74018, 74019, 74021, 77065, 77066, 77067, 93792, 94617, and 94618. The following CPT/HCPCS codes have been added to the Group 1 codes: A9597 and A9598. The following CPT/HCPCS code(s) have been deleted and therefore removed from the article: 71010, 71015, 71020, 71021, 71022, 71023, 71030, 71034, 71035, 74000, 74010, 74020, 75658, 78190, 94620, G0202, G0204, G0206, and A9599. A9599 removal is also per TN 1875, CR 10184, for NCD 220.6.20. For the following CPT/HCPCS code(s) either the short description and/or the long description has been changed: G0279, 76000, 76881, 76882, 94621, and 95930.

Information on reporting PET tracer HCPCS codes A9597 and A9598 has been added to the Group 1 Paragraph note (reference TN 3911, CR 10319).

The following CPT/HCPCS codes have been revised under the “Technician Qualification Requirements” column to allow a licensed audiologist as per the CMS audiology code list revised CY2016: 92550, 92557, 92567, 92568, 92570, 92579, 92601, 92602, 92603, and 92604. An informational note pertaining to Licensed Audiologist has been added beneath the credentialing matrix to clarify instances when a licensed audiologist would not be subject to direct physician supervision. Added reference to the CMS website for audiology services.

Effective for claims with dates of service on or after 12/15/2017, an informational note has been added to the Group 1 Paragraph regarding national non-coverage of HCPCS code A9580 (NaF-18) and due to non-coverage, HCPCS code A9580 has been removed from the Group 1 codes.
04/13/2017 R14 Article revised and published on 04/13/2017. The CPT code 51610 has been added to the Credentialing Matrix with a level of physician supervision of 03; supervising physician and interpreting physician qualification requirements of: Board Certified (ABMS) Radiologist or Urologist; and technician qualification requirements of: CRT-R.
01/01/2017 R13 Article revised and published on 01/12/2017 effective for dates of service on and after 01/01/2017 to reflect the annual CPT/HCPCS code updates. The following CPT/HCPCS code(s) have been added to the Credentialing Matrix: 76706 and 92242. The following CPT/HCPCS codes have been added to the Group 1 codes: A9515, A9587, and A9588. The following CPT/HCPCS code(s) have been deleted and therefore removed from the Article: G0389, 75791, 77051, 77052, 77055, 77056, 77057, and 93965. For the following CPT/HCPCS code(s) either the short description and/or the long description has been changed: A9599, G0202, G0204, G0206, 77002, 77003, 92083, 92235, 92240, 94060, and 0295T. Revised the Group 1 Paragraph note to clarify the use of A9599 with PET Aß imaging through CED only. Added Q9982 and Q9983 to the Group 1 Paragraph note.
11/10/2016 R12 Article revised and published on 11/10/2016. The following CPT codes have had their Supervising Physician and Interpreting Physician qualification requirements expanded to include Board Certified OB/GYN: 76830, 76856, 76857, 93975, and 93976. The following CPT codes have had their Supervising Physician and Interpreting Physician qualification requirements expanded to include Board Certified OB/GYN with subspecialty certification in Maternal Fetal Medicine (MFM): 76801, 76802, 76805, 76810, 76811, 76812, 76813, 76814, 76815, 76816, 76817, 76818, 76819, 76820, 76821, 76825, 76826, 76827, 76828 and 93325.
08/11/2016 R11 Article revised and published on 08/11/2016. The following HCPCS codes (which are new HCPCS codes as of 07/01/2016; reference CR9636) have been added to the Group 1 Codes: Q9982 and Q9983.
07/14/2016 R10 Article revised and published on 07/14/2016 effective for dates of service on and after 07/14/2016. Added CPT code 95806 to the Credentialing Matrix with a level of physician supervision of 01; supervising physician and interpreting physician qualification requirements of: ABMS Physician Certified by ABSM or ABMS: Sleep Medicine OR ABFM, ABIM, ABOto, or ABPN: Sleep Medicine Subspecialty Certification; and technician qualification requirements of: Credentialed by BRPT: RPSGT, ABRET: R. EEG T. (Polysomnography), CRT: SDS or RRT: SDS.
05/12/2016 R9 Article revised effective for dates of service on and after 05/12/2016. Added the following HCPCS codes to the Group 1 Codes: A9586 and A9599 with a coding instruction note when used for PET Aß imaging through CED. Added the following CPT codes to the Credentialing Matrix: 0295T, 0296T, and 0298T. Updated level of physician supervision for G0365 to be consistent with the 2016 CMS Physician Fee Schedule. Added hyperlink to related LCD L35448 IDTF.
04/07/2016 R8 Article revised effective for dates of service on and after 04/07/2016. Supervision levels for CPT codes 95928-95930 have been changed to 09 – Physician service. Additional statement added to CPT codes 95925-95927 and 95938-95939 technical components regarding certified PTs.
01/01/2016 R7 Article revised and published on 01/28/2016 effective for dates of service on and after 01/01/2016 to reflect the annual CPT/HCPCS code updates. The following CPT/HCPCS code(s) have been added to the Physician Supervision table of codes: 72081, 72082, 72083, 72084, 73501, 73502, 73503, 73521, 73522, 73523, 73551, 73552, 78265, 78266, 92537, and 92538. The following CPT/HCPCS code has been added to the Group 1 codes: Q9950. The following CPT/HCPCS code(s) have been deleted and therefore removed from the Article: 50394, 70373, 72010, 72069, 72090, 73500, 73510, 73520, 73530, 73540, 73550, 74305, 74320, 74327, and 92543. For the following CPT/HCPCS code(s) either the short description and/or the long description has been changed: 94060, 72080, 74241, 77417, and 78264. In response to a reconsideration request, effective for dates of service on and after 01/01/2015, the following CPT codes have been added to the Physician Supervision table of codes: 62302, 62303, 62304, and 62305.
10/19/2015 R6 Article revised and published on 12/10/2015 to add A9584 to Group 1 codes as a covered additional service performed in an IDTF effective for dates of service on or after 10/19/2015.
10/01/2015 R5 Article revised and published on 08/13/2015 to add Certified Rhythm Analysis Technician (CRAT) as a qualified technician for CPT codes 93229 and 93299.
10/01/2015 R4 Article revised and posted on 03-12-2015 to add A9575. Language requiring the submissions of a CMS 885R form for interpreting physicians has been removed.
10/01/2015 R3 Article revised and published on 01/23/2015 effective for dates of service on and after 01/01/2015 to reflect the annual CPT/HCPCS code updates. CPT/HCPCS codes 74291, 76645 and 77082 have been deleted and therefore removed from the Article. CPT/HCPCS codes 76641, 76642, 77063, 77085, 77086, 93260, 93261 and G0279 have been added to the CPT/HCPCS code group. Either the short description and/or the long description was changed for CPT/HCPCS codes 27370, 62284, 74290, 93282, 93283, 93284, 93287, 93289, 93295, 93296, 96110, G0204 and G0206. Also, CPT/HCPCS code 36415 was added to Article as an additional service effective for dates of service on or after 07/24/2014.
10/01/2015 R2 Article updated and posted on 11/14/2014 to include a listing of additional HCPCS codes that will be considered covered for services performed in an IDTF effective for dates of service on or after 10/01/2015.
10/01/2015 R1 Updated article with reference to Local Coverage Determination (LCD) L35448, for additional information.
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Medicare BPM Ch 15.50.2 SAD Determinations
Medicare BPM Ch 15.50.2
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