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Independent Diagnostic Testing Facilities- physician supervision and technician requirements

A54953

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General Information

Source Article ID
N/A
Article ID
A54953
Original ICD-9 Article ID
Not Applicable
Article Title
Independent Diagnostic Testing Facilities- physician supervision and technician requirements
Article Type
Article
Original Effective Date
04/01/2016
Revision Effective Date
02/26/2026
Revision Ending Date
N/A
Retirement Date
N/A

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Current Dental Terminology © 2025 American Dental Association. All rights reserved.

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CMS National Coverage Policy

N/A

Article Guidance

Article Text

This article is a list of diagnostic services that may be performed in an Independent Diagnostic Testing Facilities (IDTF) provided they have the appropriate physician supervision and technician requirements. The CPT codes in this document do not imply coverage of the procedure. All of the procedure codes are subject to Medicare rules and regulations, applicable Local Coverage Decisions (LCD’s), and medical necessity.

National credentialing bodies must be a member of the National Organization for Competency Assurance (NOCA) or certified by the Commission for Certifying Agencies (NCCA) which is the accreditation body of NOCA. In the absence of a National Credentialing Body, the Contractor has the discretion to approve educational requirements or other certifications. For example, we are allowing technicians who are certified by Cardiovascular Credentialing International (CCI) for cardiac monitoring services since there is no agency for those services that is recognized by NOCA or NCCA.

Supervising physicians must be board eligible or board certified. An IDTF wishing to add a supervising physician to their file that is not of the specialty listed in the appendix may send in additional information outlining their qualifications such as additional training or education to the enrollment department. The information will be reviewed by the medical staff.

Section 135(a) of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) amended section 1834(e) of the Social Security Act and required the Secretary to designate organizations to accredit suppliers, including but not limited to physicians, non-physician practitioners and Independent Diagnostic Testing Facilities, that furnish the technical component (TC) of advanced diagnostic imaging services.

MIPPA specifically defines advanced diagnostic imaging procedures as including diagnostic magnetic resonance imaging (MRI), computed tomography (CT), and nuclear medicine imaging such as positron emission tomography (PET). In order to furnish the TC of advanced diagnostic imaging services for Medicare beneficiaries the suppliers must be accredited.

The Centers for Medicare & Medicaid Services (CMS) approved 4 national accreditation organizations to provide accreditation services for suppliers of the TC of advanced diagnostic imaging procedures:

  1. American College of Radiology (ACR) 
  2. Intersocietal Accreditation Commission (IAC) 
  3. RadSite
  4. The Joint Commission (TJC)

All accreditation organizations have quality standards that address the safety of the equipment as well as the safety of the patients and staff. To obtain additional information about the accreditation process, please contact the accreditation organizations shown above.

Supplies
Certain items (e.g., radiopharmaceutical agents, special contrast agents, medications, etc.) or services that are necessary for the performance of specific diagnostic tests may also 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. The items or services may not be listed on the table. 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.

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. Each IDTF will have a specific and unique list of HCPCS codes for which it can be paid. It is the responsibility of the IDTF to obtain Contractor approval to bill each HCPCS code that it intends to bill.

Unlisted procedure codes are not included in the table below. Providers will need to send in a written request explaining the procedure they are performing. If the Contractor Medical Director (CMD) determines it to be an appropriate diagnostic procedure that can be safely performed in an IDTF, it will be added to the provider’s file.

A procedure code that includes a diagnostic and/or therapeutic procedure may be allowed in an IDTF provided the service performed is diagnostic.

The level of supervision listed on the database must be provided by 1 of the physicians listed as a supervising physician in the table below. The numeric diagnostic supervision levels assigned to each CPT or HCPCS code are found on the Medicare Physician Fee Schedule Database (MPFSDB).

These are abbreviated code descriptions of the procedures that may be allowed in an IDTF. Providers should consult a CPT book for the complete code description of the procedures they are performing/billing.

CPT/ HCPCS Codes

Description

Supervising Physician Qualification Requirements

Technician Qualification

27369

Njx cntrst kne arthg/ct/mri

Radiologist or Orthopedic Surgeon

Physician Only Service

51798

Us urine capacity measure

Urologist or Radiologist

Urology or OB/GYN Personally Trained Staff; CRT-R

70010

Contrast x-ray of brain

Radiologist

Physician Only Service

70015

Contrast x-ray of brain

Radiologist

Physician Only Service

70030

X-ray eye for foreign body

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

70100

X-ray exam of jaw<4views

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

70110

X-ray exam of jaw 4/>views

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

70120

X-ray exam of mastoids

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

70130

X-ray exam of mastoids

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

70134

X-ray exam of middle ear

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

70140

X-ray exam of facial bones

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

70150

X-ray exam of facial bones

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

70160

X-ray exam of nasal bones

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

70170

X-ray exam of tear duct

Radiologist

Physician only service

70190

X-ray exam of eye sockets

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

70200

X-ray exam of eye sockets

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

70210

X-ray exam of sinuses

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

70220

X-ray exam of sinuses

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

70240

X-ray exam, pituitary saddle

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

70250

X-ray exam of skull

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

70260

X-ray exam of skull

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

70300

X-ray exam of teeth

Radiologist/DDS/ Maxofacial Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

70310

X-ray exam of teeth

Radiologist/DDS/ Maxofacial Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

70320

Full mouth x-ray of teeth

Radiologist/DDS/ Maxofacial Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

70328

X-ray exam of jaw joint

Radiologist/DDS/ Maxofacial Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

70330

X-ray exam of jaw joints

Radiologist/DDS/ Maxofacial Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

70332

X-ray exam of jaw joint

Radiologist/DDS/ Maxofacial Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

70336

Magnetic image, jaw joint

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

70350

X-ray head for orthodontia

Radiologist/DDS/ Maxofacial Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

70355

Panoramic x-ray of jaws

Radiologist/DDS/ Maxofacial Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

70360

X-ray exam of neck

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

70370

Throat x-ray & fluoroscopy

Radiologist

Physician Only Service

70371

Speech evaluation, complex

Radiologist

Physician Only Service

70380

X-ray exam of salivary gland

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

70390

X-ray exam of salivary duct

Radiologist

Physician Only Service

70450

CT head/brain w/o dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

70460

CT head/brain w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

70470

CT head/brain w/o & w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

70471

CTA h&n c+ w/noncontrast img

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

70480

CT orbit/ear/fossa w/o dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

70481

CT orbit/ear/fossa w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

70482

CT orbit/ear/fossa w/o& w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

70486

CT maxillofacial w/o dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

70487

CT maxillofacial w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

70488

CT maxillofacial w/o & w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

70490

CT soft tissue neck w/o dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

70491

CT soft tissue neck w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

70492

CT sft tsue nck w/o & w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

70496

CT angiography, head

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

70498

CT angiography, neck

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

70540

MRI orbit/face/neck w/o dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

70542

MRI orbit/face/neck w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

70543

MRI orbt/fac/nck w/o & w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

70544

MR angiography head w/o dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RTMR

70545

MR angiography head w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

70546

MR angiograph head w/o&w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

70547

MR angiography neck w/o dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

70548

MR angiography neck w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

70549

MR angiograph neck w/o&w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

70551

MRI brain w/o dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

70552

MRI brain w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

70553

MRI brain w/o & w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

70554

FMRI brain by tech

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

70555

FMRI brain by phys/psych

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

70557

MRI brain w/o dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

70558

MRI brain w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

70559

MRI brain w/o & w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

71045

X-ray exam chest 1 view

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

71046

X-ray exam chest 2 views

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

71047

X-ray exam chest 3 views

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

71048

X-ray exam chest 4+ views

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

71100

X-ray exam of ribs uni 2 views

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

71101

X-ray exam of ribs/chest

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

71110

X-ray exam of ribs bil 3 views

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

71111

X-ray exam of ribs/chest 4/>vws

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

71120

X-ray exam of sternum 2/>vws

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

71130

X-ray exam of sternoclavic jt 3/>vws

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

71250

Ct thorax dx c

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

71260

Ct thorax dx c+

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

71270

Ct thorax dx c-/c+

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

71271

Low dose CT scan of chest for lung cancer screening

Radiologist-board certification or board eligibility with the American Board of Radiology or equivalent organization.

Certified Radiologic Technologist (ARRT:R.T.-CT)

71275

CT angiography, chest

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

71550

MRI chest w/o dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

71551

MRI chest w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

71552

MRI chest w/o & w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

71555

MR angio chest w or w/o dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

72020

X-ray exam of spine 1 view

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

72040

X-ray exam of neck spine 2-3 vw

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

72050

X-ray exam of neck spine 4/5 vws

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

72052

X-ray exam of neck spine 6/> vw

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

72070

X-ray exam of thoracic spine 2 vws

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

72072

X-ray exam of thoracic spine 3 vws

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

72074

X-ray exam of thoracic spine 4/>vw

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

72080-72084

X-ray exam thoracolmb 2/>vw-

X-ray exam entire spi 6/>vw

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

72100

X-ray exam l-s spine 2/3 vws

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

72110

X-ray exam l-s spine 4/>vws

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

72114

X-ray exam l-s spine bending

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

72120

X-ray bend only l-s spine

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

72125

CT neck spine w/o dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

72126

CT neck spine w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

72127

CT neck spine w/o & w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

72128

CT chest spine w/o dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

72129

CT chest spine w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

72130

CT chest spine w/o & w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

72131

CT lumbar spine w/o dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

72132

CT lumbar spine w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

72133

CT lumbar spine w/o & w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

72141

MRI neck spine w/o dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

72142

MRI neck spine w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

72146

MRI chest spine w/o dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

72147

MRI chest spine w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

72148

MRI lumbar spine w/o dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

72149

MRI lumbar spine w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

72156

MRI neck spine w/o & w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

72157

MRI chest spine w/o & w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

72158

MRI lumbar spine w/o & w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

72159

MRA spinal canal/contents, w & w/o dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

72170

X-ray exam of pelvis

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

72190

X-ray exam of pelvis

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

72191

CT angiograph pelv w/o&w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

72192

CT pelvis w/o dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

72193

CT pelvis w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

72194

CT pelvis w/o & w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

72195

MRI pelvis w/o dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

72196

MRI pelvis w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

72197

MRI pelvis w/o & w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

72198

MRI angio pelvis w/o & w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

72200

X-ray exam si joints

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

72202

X-ray exam si joints 3/>vws

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

72220

X-ray exam sacrum tailbone

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

72240

Myelography neck spine

Radiologist

Physician Only Service

72255

Myelography thorax spine

Radiologist

Physician Only Service

72265

Myelography l-s spine

Radiologist

Physician Only Service

72270

Myelography 2/> spine regions

Radiologist

Physician Only Service

72285

Discography cerv/thor spine

Radiologist

Physician Only Service

72295

X-ray of lower spine disk

Radiologist

Physician Only Service

73000

X-ray exam of collar bone

Radiologist or Orthopedic Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

73010

X-ray exam of shoulder blade

Radiologist or Orthopedic Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

73020

X-ray exam of shoulder

Radiologist or Orthopedic Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

73030

X-ray exam of shoulder

Radiologist or Orthopedic Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

73040

Contrast x-ray of shoulder

Radiologist or Orthopedic Surgeon

Physician Only Service

73050

X-ray exam of shoulders

Radiologist or Orthopedic Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

73060

X-ray exam of humerus

Radiologist or Orthopedic Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

73070

X-ray exam of elbow

Radiologist or Orthopedic Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

73080

X-ray exam of elbow

Radiologist or Orthopedic Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

73085

Contrast x-ray of elbow

Radiologist or Orthopedic Surgeon

Physician Only Service

73090

X-ray exam of forearm

Radiologist or Orthopedic Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

73092

X-ray exam of arm, infant

Radiologist or Orthopedic Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

73100

X-ray exam of wrist

Radiologist or Orthopedic Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

73110

X-ray exam of wrist

Radiologist or Orthopedic Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

73115

Contrast x-ray of wrist

Radiologist or Orthopedic Surgeon

Physician Only Service

73120

X-ray exam of hand

Radiologist or Orthopedic Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

73130

X-ray exam of hand

Radiologist or Orthopedic Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

73140

X-ray exam of finger(s)

Radiologist or Orthopedic Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

73200

CT upper extremity w/o dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

73201

CT upper extremity w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

73202

CT uppr extremity w/o&w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

73206

CT angio upr extrm w/o&w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

73218

MRI upper extremity (UE) w/o dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

73219

MRI UE w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

73220

MRI UE w/o & W/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

73221

MRI joint UE w/o dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

73222

MRI joint UE w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

73223

MRI joint UE w/o & w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

73225

MRA UE w/dye & w/o dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

73501-73503

X-ray exam hip uni 1 view-

X-ray exam hip uni 4/> views

Radiologist or Orthopedic Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

73521-73523

X-ray exam hips bi 2 views-

X-ray exam hips bi 5/> views

Radiologist or Orthopedic Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

73525

Contrast x-ray of hip

Radiologist or Orthopedic Surgeon

Physician Only Service

73551 & 73552

X-ray exam of femur 1-

X-ray exam femur 2/>

Radiologist or Orthopedic Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

73560

X-ray exam of knee, 1 or 2

Radiologist or Orthopedic Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

73562

X-ray exam of knee, 3

Radiologist or Orthopedic Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

73564

X-ray exam, knee, 4 or more

Radiologist or Orthopedic Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

73565

X-ray exam of knees

Radiologist or Orthopedic Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

73580

Contrast x-ray of knee joint

Radiologist or Orthopedic Surgeon

Physician Only Service

73590

X-ray exam of lower leg

Radiologist or Orthopedic Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

73592

X-ray exam of leg, infant

Radiologist or Orthopedic Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

73600

X-ray exam of ankle

Radiologist or Orthopedic Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

73610

X-ray exam of ankle

Radiologist or Orthopedic Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

73615

Contrast x-ray of ankle

Radiologist or Orthopedic Surgeon

Physician Only Service

73620

X-ray exam of foot

Radiologist or Orthopedic Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

73630

X-ray exam of foot

Radiologist or Orthopedic Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

73650

X-ray exam of heel

Radiologist or Orthopedic Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

73660

X-ray exam of toe(s)

Radiologist or Orthopedic Surgeon

Certified Radiologic Technologist (ARRT:R.T.-R)

73700

CT lower extremity w/o dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

73701

CT lower extremity w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

73702

CT lwr extremity w/o&w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

73706

CT angio lwr extr w/o&w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

73718

MRI lower extremity w/o dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

73719

MRI lower extremity w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

73720

MRI lwr extremity w/o & w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

73721

MRI jnt of lwr extre w/o dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

73722

MRI joint of lwr extr w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

73723

MRI joint lwr extr w/o&w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

73725

MRA lwr ext w or w/o dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

74018

X-ray exam abdomen 1 view

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

74019

X-ray exam abdomen 2 views

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

74021

X-ray exam abdomen 3 + views

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

74022

X-ray exam complete abdomen

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

74150

CT abdomen w/o dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

74160

CT abdomen w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

74170

CT abdomen w/o & w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

74174

CT angio abd&pelv w/o & w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

74175

CT angio abdom w/o & w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

74176

CT abd & pelvis w/o contrast

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

74177

CT abd & pelvis with contrast

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

74178

CT abd & pelv1/> regns

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

74181

MRI abdomen w/o dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

74182

MRI abdomen w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

74183

MRI abdomen w/o & w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

74185

MRI angio, abd w or w/o dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

74190

X-ray exam of peritoneum

Radiologist

Physician Only Service

74210

X-ray xm phrnx&/crv esoph c+

Radiologist

Physician Only Service

74220

X-ray xm esophagus 1cntrst

Radiologist

Physician Only Service

74221

X-ray xm esophagus 2cntrst

Radiologist

Physician Only Service

74230

X-ray xm swlng funcj c+

Radiologist

Physician Only Service

74240

X-ray xm upr gi trc 1cntrst

Radiologist

Physician Only Service

74246

X-ray xm upr gi trc 2cntrst

Radiologist

Physician Only Service

74248

X-ray sm int f-thru std

Radiologist

Physician Only Service

74250

X-ray xm sm int 1cntrst std

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

74251

X-ray xm sm int 2cntrst std

Radiologist

Physician Only Service

74261

CT colonography dx

Radiologist

Certified Radiologic Technologist (ARRT:R.T. .-CT)

74262

CT colonography dx w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T. .-CT)

74263

CT colonography screening

Radiologist

Certified Radiologic Technologist (ARRT:R.T. .-CT)

74270

X-ray xm colon 1cntrst std

Radiologist

Physician Only Service

74280

X-ray xm colon 2cntrst std

Radiologist

Physician Only Service

74283

Ther nma rdctj intus/obstrcj

Radiologist

Physician Only Service

74290

Contrast x-ray, gallbladder

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

74300

X-ray bile ducts/pancreas

Radiologist

Physician Only Service

74301

X-rays at surgery add-on

Radiologist

Physician Only Service

74328

X-ray bile duct endoscopy

Radiologist

Physician Only Service

74329

X-ray for pancreas endoscopy

Radiologist

Physician Only Service

74330

X-ray bile/panc endoscopy

Radiologist

Physician Only Service

74400

Contrst x-ray, urinary tract

Radiologist or Urologist

Certified Radiologic Technologist (ARRT:R.T.-R)

74410

Contrst x-ray, urinary tract

Radiologist or Urologist

Certified Radiologic Technologist (ARRT:R.T.-R)

74415

Contrst x-ray, urinary tract

Radiologist or Urologist

Certified Radiologic Technologist (ARRT:R.T.-R)

74420

Contrst x-ray, urinary tract

Radiologist or Urologist

Physician Only Service

74425

Urography antegrade rs&i

Radiologist or Urologist

Physician Only Service

74430

Contrast x-ray, bladder

Radiologist or Urologist

Physician Only Service

74440

X-ray, male genital tract

Radiologist or Urologist

Physician Only Service

74445

X-ray exam of penis

Radiologist or Urologist

Physician Only Service

74450

X-ray, urethra/bladder

Radiologist or Urologist

Physician Only Service

74455

X-ray, urethra/bladder

Radiologist or Urologist

Physician Only Service

74470

X-ray exam of kidney lesion

Radiologist or Urologist

Physician Only Service

74710

X-ray measurement of pelvis

Radiologist or OBGYN

Certified Radiologic Technologist (ARRT:R.T.-R)

74712 & 74713

MRI fetal sngl/1st gestation-

MRI ea addl gestation

Radiologist or OBGYN

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

74740

X-ray, female genital tract

Radiologist or OBGYN

Physician Only Service

74742

X-ray, fallopian tube

Radiologist or OBGYN

Physician Only Service

74775

X-ray exam of perineum

Radiologist or OBGYN

Physician Only Service

75557

Cardiac MRI for morph

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

75559

Cardiac MRI w/stress img

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

75561

Cardiac MRI for morph w/dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

75563

Card MRI w/stress img & dye

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

75565

Card MRI veloc flow mapping

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

75571

CT hrt w/o dye w/ca test

Radiologist/Cardiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

75572

CT hrt w/3d image

Radiologist/Cardiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

75573

Ct hrt strux cgen hrt ds

Radiologist/Cardiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

75574

CT angio hrt w/3d image

Radiologist/Cardiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

75600

Contrast exam thoracic aorta

Radiologist ,Vascular Surgery

Physician Only Service

75605

Contrast exam thoracic aorta

Radiologist, Vascular Surgery

Physician Only Service

75625

Contrast exam abdominl aorta

Radiologist, Vascular Surgery

Physician Only Service

75630

X-ray aorta, leg arteries

Radiologist,Vascular Surgery

Physician Only Service

75635

CT angio abdominal arteries

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

75705

Artery x-rays, spine

Radiologist,Vascular Surgery

Physician Only Service

75710

Artery x-rays, arm/leg

Radiologist,Vascular Surgery

Physician Only Service

75716

Artery x-rays, arms/legs

Radiologist,Vascular Surgery

Physician Only Service

75726

Artery x-rays, abdomen

Radiologist,Vascular Surgery

Physician Only Service

75731

Artery x-rays, adrenal gland

Radiologist,Vascular Surgery

Physician Only Service

75733

Artery x-rays, adrenals

Radiologist,Vascular Surgery

Physician Only Service

75736

Artery x-rays, pelvis

Radiologist,Vascular Surgery

Physician Only Service

75741

Artery x-rays, lung

Radiologist,Vascular Surgery

Physician Only Service

75743

Artery x-rays, lungs

Radiologist,Vascular Surgery

Physician Only Service

75746

Artery x-rays, lung

Radiologist,Vascular Surgery

Physician Only Service

75756

Artery x-rays, chest

Radiologist,Vascular Surgery

Physician Only Service

75774

Artery x-ray, each vessel

Radiologist,Vascular Surgery

Physician Only Service

75801

Lymph vessel x-ray, arm/leg

Radiologist

Physician Only Service

75803

Lymph vessel x-ray, arms/legs

Radiologist

Physician Only Service

75805

Lymph vessel x-ray, trunk

Radiologist

Physician Only Service

75807

Lymph vessel x-ray, trunk

Radiologist

Physician Only Service

75809

Nonvascular shunt, x-ray

Radiologist

Physician Only Service

75810

Vein x-ray, spleen/liver

Radiologist, Vascular Surgery

Physician Only Service

75820

Vein x-ray, arm/leg

Radiologist, Vascular Surgery

Physician Only Service

75822

Vein x-ray, arms/legs

Radiologist, Vascular Surgery

Physician Only Service

75825

Vein x-ray, trunk

Radiologist, Vascular Surgery

Physician Only Service

75827

Vein x-ray, chest

Radiologist, Vascular Surgery

Physician Only Service

75831

Vein x-ray, kidney

Radiologist, Vascular Surgery

Physician Only Service

75833

Vein x-ray, kidneys

Radiologist, Vascular Surgery

Physician Only Service

75840

Vein x-ray, adrenal gland

Radiologist, Vascular Surgery

Physician Only Service

75842

Vein x-ray, adrenal glands

Radiologist, Vascular Surgery

Physician Only Service

75860

Vein x-ray, neck

Radiologist, Vascular Surgery

Physician Only Service

75870

Vein x-ray, skull

Radiologist, Vascular Surgery

Physician Only Service

75872

Vein x-ray, skull epidural

Radiologist, Vascular Surgery

Physician Only Service

75880

Vein x-ray, eye socket

Radiologist, Vascular Surgery

Physician Only Service

75885

Vein x-ray, liver w/hemodynam

Radiologist, Vascular Surgeon

Physician Only Service

75887

Vein x-ray, liver w/o hemodyn

Radiologist, Vascular Surgeon

Physician Only Service

75889

Vein x-ray, liver w/hemodynam

Radiologist, Vascular Surgeon

Physician Only Service

75891

Vein x-ray, liver

Radiologist, Vascular Surgeon

Physician Only Service

75893

Venous sampling by catheter

Radiologist, Vascular Surgeon

Physician Only Service

75898

Follow-up angiography

Radiologist, Vascular Surgeon

Physician Only Service

76000

Fluoroscopy <1 hr phys/qhp

Radiologist or in the field related to the Primary Procedure

Physician Only Service

76010

X-ray, nose to rectum

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

76014

MRI, implant/foreign body assessment

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

76015

MRI, implant/foreign body assessment

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

76016

MRI, determination of safety

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

76017

MRI, risk-mitigation by medical physicist

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR or Medical Physicist

76018

MRI, implanted medical device electronics preparation

Radiologist, Cardiologist, Neurologist, or Neurosurgeon

Certified Radiologic Technologist (ARRT:R.T.-MR), ARMRIT-RT-MR or RN, CCI-CCT, NCCT-NCET, NHA-CET

76019

MRI, implanted medical device protections

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR

76376

3D render w/intrp postproces

Radiologist/Cardiologist

(ARRT:R.T.-CT or (ARRT:R.T.-MR) or ARMRIT-MR or ARDMS- RDCS

76377

3D render w/intrp postproces

Radiologist/Cardiologist

(ARRT:R.T.-CT or (ARRT:R.T.-MR) or ARMRIT-MR or ARDMS- RDCS

76380

CAT scan follow-up study

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

76391

Mr elastography

Radiologist

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

76506

Echo exam of head

Radiologist or Neurologist

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

76510

Ophth US b & quant a

Ophthalmologist, optometrist or Radiologist

Credentialed by JCAHPO - COMT

76511

Ophth US quant a only

Ophthalmologist, optometrist or Radiologist

Credentialed by JCAHPO - COMT

76512

Ophth US b w/non-quant a

Ophthalmologist, optometrist or Radiologist

Credentialed by JCAHPO - COMT

76513

Oph us dx ant sgm us uni/bi

Ophthalmologist or Radiologist

Credentialed by JCAHPO- COMT

76514

Echo exam of eye, thickness

Ophthalmologist, optometrist or Radiologist

Credentialed by JCAHPO - COMT

76516

Echo exam of eye

Ophthalmologist, optometrist or Radiologist

Credentialed by JCAHPO- COMT

76519

Echo exam of eye

Ophthalmologist, optometrist or Radiologist

Credentialed by JCAHPO- COMT

76529

Echo exam of eye

Ophthalmologist or Radiologist

Credentialed by JCAHPO- COMT

76536

US exam of head and neck

Radiologist or Neurologist

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

76604

US exam, chest

Radiologist

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

76641

US breast complete

Radiologist

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

76642

US breast limited

Radiologist

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

76700

US exam, abdom complete

Radiologist

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

76705

Echo exam of abdomen

Radiologist

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

76706

US abdl aorta screen aaa

Radiologist

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

76770

US exam abdo back wall, comp

Radiologist

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

76775

US exam abdo back wall, lim

Radiologist

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

76776

US exam k translp w/doppler

Radiologist

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

76800

US exam, spinal canal

Radiologist

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

76801

Ob US < 14 wks, single fetus

Radiologist/OBGYN

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

76802

Ob US < 14 wks, addl fetus

Radiologist/OBGYN

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

76805

Ob US >/= 14 wks, sngl fetus

Radiologist/OBGYN

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

76810

Ob US >/= 14 wks, addl fetus

Radiologist/OBGYN

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

76811

Ob US, detailed, sngl fetus

Radiologist/OBGYN

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

76812

Ob US, detailed, addl fetus

Radiologist/OBGYN

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

76813

Ob US, nuchal meas 1 gest

Radiologist/OBGYN

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

76814

Ob US, nuchal meas add-on

Radiologist/OBGYN

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

76815

Ob US, limited, fetus(s)

Radiologist/OBGYN

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

76816

Ob US, follow-up, per fetus

Radiologist/OBGYN

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

76817

Transvaginal US obstetric

Radiologist/OBGYN

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

76818

Fetal biophys profile w/nst

Radiologist/OBGYN

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

76819

Fetal biophys profil w/o nst

Radiologist/OBGYN

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

76820

Umbilical artery echo

Radiologist/OBGYN

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

76821

Middle cerebral artery echo

Radiologist/OBGYN

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

76825

Echo exam of fetal heart

Radiologist or OB/GYN/Cardiology

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

76826

Echo exam of fetal heart

Radiologist or OB/GYN/Cardiology

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

76827

Echo exam of fetal heart

Radiologist or OB/GYN/Cardiology

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

76828

Echo exam of fetal heart

Radiologist or OB/GYN/Cardiology

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

76830

Transvaginal US non-ob

Radiologist or OB/GYN

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

76831

Echo exam, uterus

Radiologist or OB/GYN

Physician Only Service

76856

US exam, pelvic, complete

Radiologist or OB/GYN

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

76857

US exam, pelvic, limited

Radiologist or OB/GYN

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

76870

US exam, scrotum

Radiologist or Urologist

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

76872

US, transrectal

Radiologist or OB/GYN, Urologist

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

76873

Echograp trans r, pros study

Radiologist or Urologist

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

76881

US compl joint r-t w/img

Radiologist

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

76882

US lmtd jt/nonvasc xtr strux

Radiologist

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

76885

US exam infant hips dynamic

Radiologist

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

76886

US exam infant hips, static

Radiologist

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

76932

Echo guide for heart biopsy

Radiologist /Cardiologist

Physician Only Service

76937

US guide, vascular access

Radiologist, Vascular Surgeon

Physician Only Service

76940

US guide, tissue ablation

Radiologist

Physician Only Service

76945

Echo guide, villus sampling

Radiologist

Physician Only Service

76946

Echo guide for amniocentesis

Radiologist

Physician Only Service

76975

GI endoscopic ultrasound

Radiologist

Physician Only Service

76977

US bone density measure

Radiologist/Multiple physician specialties

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

76978

Us trgt dyn mbubb 1st les

Radiologist

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

76979

Us trgt dyn mbubb ea addl

Radiologist

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

76981

Use parenchyma

Radiologist

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

76982

Use 1st target lesion

Radiologist

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

76983

Use ea addl target lesion

Radiologist

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

77002

Needle localization by x-ray

Radiologist or in the field related to the Primary Procedure

Physician Only Service

77003

Fluoroguide for dx spine inject

Radiologist or in the field related to the Primary Procedure

Physician Only Service

77011

CT scan for localization

Radiologist

Physician Only Service

77012

CT scan for needle biopsy

Radiologist

Physician Only Service

77021

MRI guidance ndl plmt rs&i

Radiologist

Physician Only Service

77046

Mri breast c- unilateral

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-MR

77047

Mri breast c- bilateral

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-MR

77048

Mri breast c-+ w/cad uni

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-MR

77049

Mri breast c-+ w/cad bi

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-MR

77053

X-ray of mammary duct

Radiologist

Physician Only Service

77054

X-ray of mammary ducts

Radiologist

Physician Only Service

77061

breast tomosynthesis-uni

Radiologist

Facility Must be FDA Certified to Perform Mammography Certified Radiologic Technologist (ARRT:R.T.-R)

77062

Breast tomosynthesis bi

Radiologist

Facility Must be FDA Certified to Perform Mammography Certified Radiologic Technologist (ARRT:R.T.-R)

77063

Breast tomosynthesis bi

Radiologist

Facility Must be FDA Certified to Perform Mammography Certified Radiologic Technologist (ARRT:R.T.-R)

77065

Dx mammography including CAD, unilateral

Radiologist

Facility Must be FDA Certified to Perform Mammography Certified Radiologic Technologist (ARRT:R.T.-R)

77066

Dx mammography including CAD, bilateral

Radiologist

Facility Must be FDA Certified to Perform Mammography Certified Radiologic Technologist (ARRT:R.T.-R)

77067

Screening, bilateral including CAD

Radiologist

Facility Must be FDA Certified to Perform Mammography Certified Radiologic Technologist (ARRT:R.T.-R)

77071

X-ray stress view

Radiologist

Physician Only Service

77072

X-rays for bone age

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

77073

X-rays, bone length studies

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

77074

X-rays, bone survey limited

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

77075

X-rays, bone survey complete

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

77076

X-rays, bone survey infant

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

77077

Joint survey, single view

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-R)

77078

CT bone density, axial

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-CT)

77080

DXA bone density, axial

Radiologist or Internal Medicine

Certified Radiologic Technologist (ARRT:R.T.-BD), CDT, CBDT

77081

DXA bone density/peripheral

Radiologist or Internal Medicine

Certified Radiologic Technologist (ARRT:R.T.-BD), CDT, CBDT

77084

Magnetic image bone marrow

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-MR

77085

DXA bone density study

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-BD), CDT, CBDT

77086

Fracture assessment via DXA

Radiologist

Certified Radiologic Technologist (ARRT:R.T.-BD), CDT, CBDT

77089

Trabecular bone score (TBS) -prep and transmission

Radiologist or Internal Medicine

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-MR

77090

TBS -prep and transmission-performed elsewhere

Radiologist or Internal Medicine

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-MR

77091

TBS technical calculation only

Radiologist or Internal Medicine

Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-MR

78012

Thyroid uptake measurement

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78013

Thyroid imaging w/blood flow

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78014

Thyroid imaging w/blood flow

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78015

Thyroid met imaging

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78016

Thyroid met imaging/studies

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78018

Thyroid met imaging, body

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78020

Thyroid met uptake

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78070

Parathyroid planar imaging

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78071

Parathyrd planar w/wo subrtrj

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78072

Parathyrd planar w/SPECT&CT

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78075

Adrenal cortex & medulla img

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78102

Bone marrow imaging, ltd

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78103

Bone marrow imaging, mult

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78104

Bone marrow imaging, body

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78110

Plasma volume, single

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78111

Plasma volume, multiple

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78120

Red cell mass, single

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78121

Red cell mass, multiple

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78122

Blood volume

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78130

Red cell survival study

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78140

Red cell sequestration

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78185

Spleen imaging

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78191

Platelet survival

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78195

Lymph system imaging

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78201

Liver imaging

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78202

Liver imaging with flow

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78215

Liver and spleen imaging

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78216

Liver & spleen image/flow

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78226

Hepatobiliary system imaging

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78227

Hepatobil syst image w/drug

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78230

Salivary gland imaging

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78231

Serial salivary imaging

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78232

Salivary gland function exam

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78258

Esophageal motility study

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78261

Gastric mucosa imaging

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78262

Gastroesophageal reflux exam

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78264-78266

Gastric emptying study….

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78278

Acute GI blood loss imaging

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78282

GI protein loss exam

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78290

Meckel’s divert exam

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78291

Leveen/shunt patency exam

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78300

Bone imaging, limited area

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78305

Bone imaging, multiple areas

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78306

Bone imaging, whole body

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78315

Bone imaging, 3 phase

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78350

Bone mineral single photon

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78351

Bone mineral dual photon

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78414

Non-imaging heart function

Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78428

Cardiac shunt imaging

Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78429

Myocrd img pet 1 std w/ct

Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78430

Myocrd img pet rst/strs w/ct

Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78431

Myocrd img pet rst&strs ct

Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78432

Myocrd img pet 2rtracer

Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78433

Myocrd img pet 2rtracer ct

Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78434

Aqmbf pet rest & rx stress

Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78445

Vascular flow imaging

Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78451

Ht muscle image SPECT sing

Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78452

Ht muscle image SPECT mult

Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78453

Ht muscle image planar sing

Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78454

Ht musc image planar mult

Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78456

Acute venous thrombus image

Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78457

Venous thrombosis imaging

Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78458

Ven thrombosis images, bilat

Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78459

Myocrd img pet single study

Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78466

Heart infarct image

Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78468

Heart infarct image (ef)

Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78469

Heart infarct image (3D)

Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78472

Gated heart, planar, single

Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78473

Gated heart, multiple

Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78481

Heart first pass, single

Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78483

Heart first pass, multiple

Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78491

Myocrd img pet 1std rst/strs

Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78492

Heart image (PET) multiple

Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78494

Heart image, SPECT

Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78496

Heart first pass add-on

Nuclear Medicine, Cardiology or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78579

Lung ventilation imaging

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78580

Lung perfusion imaging

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78582

Lung ventilat&perfus imaging

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78597

Lung perfusion differential

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78598

Lung perf&ventilat diferentl

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78600

Brain imaging <4 views

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78601

Brain imaging w/flow <4 views

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78605

Brain image 4+ views

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78606

Brain image w/flow 4+ views

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78608

Brain imaging (PET)

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78609

Brain imaging (PET)

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78610

Brain flow imaging only

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78630

Cerebrospinal fluid scan

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78635

CSF ventriculography

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78645

CSF shunt evaluation

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78650

CSF leakage imaging

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78660

Nuclear exam of tear flow

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78700

Kidney imaging morphol

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78701

Kidney imaging with flow

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78707

K flow/funct image w/o drug

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78708

K flow/funct image w/drug

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78709

K flow/funct image multiple

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78725

Kidney function study

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78730

Urinary bladder retention

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78740

Ureteral reflux study

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78761

Testicular imaging w/flow

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78800

Rp loclzj tum 1 area 1 d img

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78801

Rp loclzj tum 2+area 1+d img

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78802

Rp loclzj tum whbdy 1 d img

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78803

Rp loclzj tum spect 1 area

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78804

Rp loclzj tum whbdy 2+d img

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78811

PET image ltd area

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78812

PET image skull-thigh

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78813

PET image full body

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78814

PET image w/CT lmtd

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78815

PET image w/CT skull-thigh

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78816

PET image w/CT full body

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78830

Rp loclzj tum spect w/ct 1

 

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78831

Rp loclzj tum spect 2 areas

 

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78832

Rp loclzj tum spect w/ct 2

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

78835

Rp quan meas single area

Nuclear Medicine or Radiology

Credentialed by ARRT:R.T.-N or CNMT

91010

Esophagus motility study

Gastroenterologist

GI trained RN, LPN

91013

Esophgl motil w/stim/perfus

Gastroenterologist

GI trained RN, LPN

91020

Gastric motility studies

Gastroenterologist

GI trained RN, LPN

91022

Duodenal motility study

Gastroenterologist

GI trained RN, LPN

91030

Acid perfusion of esophagus

Gastroenterologist

GI trained RN, LPN

91034

Gastroesophageal reflux test

Gastroenterologist

GI trained RN, LPN

91035

G-esoph reflx tst w/ electrod

Gastroenterologist

GI trained RN, LPN

91037

Esoph imped function test

Gastroenterologist

GI trained RN, LPN

91038

Esoph imped funct test > 1h

Gastroenterologist

GI trained RN, LPN

91040

Esoph balloon distension tst

Gastroenterologist

GI trained RN, LPN

91065

Breath hydrogen/methane test

Gastroenterologist

GI trained RN, LPN

91110

GI tract Capsule endoscopy

Gastroenterologist

GI trained RN, LPN

91112

GI Transit and pressure-stomach through colon,, wireless capsule

Gastroenterologist

GI trained RN, LPN

91117

Colon motility 6 hr study

Gastroenterologist

GI trained RN, LPN

91120

Rectal sensation test

Gastroenterologist or Colorectal Surgeon

GI trained RN, LPN

91122

Anal pressure record

Gastroenterologist or Colorectal Surgeon

GI trained RN, LPN

91132

Electrogastrography

Gastroenterologist or Colorectal Surgeon

Physician Only Service

91133

Electrogastrography w/test

Gastroenterologist or Colorectal Surgeon

Physician Only Service

91200

Liver elastography

Gastroenterologist or Colorectal Surgeon

Physician Only Service

92081

Visual field examination(s)

Ophthalmologist, Neurologist or Optometrist

Credentialed by JCAHPO: COMT

92082

Visual field examination(s)

Ophthalmologist, Neurologist or Optometrist

Credentialed by JCAHPO: COMT

92083

Visual field examination(s)

Ophthalmologist, Neurologist or Optometrist

Credentialed by JCAHPO: COMT

92100

Serial tonometry exam(s)

Ophthalmologist,

Credentialed by JCAHPO: COMT

92132

Cmptr ophth dx img ant segmt

Ophthalmologist or Optometrist

Credentialed by JCAHPO: COMT

92133

Cmptr ophth img optic nerve

Ophthalmologist or Optometrist

Credentialed by JCAHPO: COMT

92134

Cmptr ophth dx img post segmt

Ophthalmologist or Optometrist

Credentialed by JCAHPO: COMT

92136

Ophthalmic biometry

Ophthalmologist or Optometrist

Credentialed by JCAHPO: COMT

92201

Opscpy extnd rta draw uni/bi

Ophthalmologist or Optometrist

Credentialed by JCAHPO: COMT

92202

Opscpy extnd on/mac draw

Ophthalmologist or Optometrist

Credentialed by JCAHPO: COMT

92227

Img rta detcj/mntr ds staff

Ophthalmologist or Optometrist

Credentialed by JCAHPO: COMT

92228

Img rta detc/mntr ds phy/qhp

Ophthalmologist or Optometrist

Credentialed by JCAHPO: COMT

92229

Img rta detc/mntr ds poc aly

Ophthalmologist or Optometrist

Credentialed by JCAHPO: COMT

92230

Eye exam with photos

Ophthalmologist or Optometrist

Credentialed by JCAHPO: COMT

92235

Fluorescein angrph uni/bi

Ophthalmologist, Neurologist or Optometrist

Credentialed by JCAHPO: COMT

92240

ICG angiography uni/bi

Ophthalmologist, Neurologist or Optometrist

Credentialed by JCAHPO: COMT

92242

Fluorescein ICG angiography

Ophthalmologist, Neurologist or Optometrist

Credentialed by JCAHPO: COMT

92250

Eye exam with photos

Ophthalmologist, Neurologist or Optometrist

Credentialed by JCAHPO: COMT

92260

Ophthalmoscopy/dynamometry

Ophthalmologist

Physician Only Service

92265

Eye muscle evaluation

Ophthalmologist, Neurologist or Optometrist

Physician Only Service

92270

Electro-oculography

Ophthalmologist, Neurologist or Optometrist

Credentialed by JCAHPO: COMT

92273

Full field erg w/i&r

 

Ophthalmologist, Neurologist or Optometrist

Credentialed by JCAHPO: COMT

92274

Multifocal erg w/i&r

Ophthalmologist, Neurologist or Optometrist

Credentialed by JCAHPO: COMT

92283

Color vision examination

Ophthalmologist, Neurologist or Optometrist

Credentialed by JCAHPO: COMT

92284

Dark adaptation eye exam

Ophthalmologist, Neurologist or Optometrist

Credentialed by JCAHPO: COMT

92285

Eye photography

Ophthalmologist, Neurologist or Optometrist

Credentialed by JCAHPO: COMT

92286

Internal eye photography

Ophthalmologist, Neurologist or Optometrist

Credentialed by JCAHPO: COMT

92287

Internal eye photography

Ophthalmologist

Physician Only Service

92517

Vemp test i&r cervical

Otolaryngologists Audiologists

Audiologist

92518

Vemp test i&r ocular

Otolaryngologists or Audiologists

Audiologist

92519

Vemp tst i&r cervical&ocular

Otolaryngologists or Audiologists

Audiologist

92537

Caloric vstblr test w/rec

Neurologist or Otolaryngologist

Audiologist

92538

Caloric vstblr test w/rec

Neurologist or Otolaryngologist

Audiologist

92540

Basic vestibular evaluation

Neurologist or Otolaryngologist

Audiologist

92541

Spontaneous nystagmus test

Neurologist or Otolaryngologist

Audiologist

92542

Positional nystagmus test

Neurologist or Otolaryngologist

Audiologist

92544

Optokinetic nystagmus test

Neurologist or Otolaryngologist

Audiologist

92545

Oscillating tracking test

Neurologist or Otolaryngologist

Audiologist

92546

Sinusoidal rotational test

Neurologist or Otolaryngologist

Audiologist

92547

Supplemental electrical test

Neurologist or Otolaryngologist

Audiologist

92548

Cdp-sot 6 cond w/i&r

Neurologist or Otolaryngologist

Audiologist

92549

Cdp-sot 6 cond w/i&r mct&adt

Neurologist or Otolaryngologist

Audiologist

92550

Tympanometry & reflex thresh

Neurologist or Otolaryngologist

Audiologist

92552

Pure tone audiometry, air

Neurologist or Otolaryngologist

Audiologist

92553

Audiometry, air & bone

Neurologist or Otolaryngologist

Audiologist

92555

Speech threshold audiometry

Neurologist or Otolaryngologist

Audiologist

92556

Speech audiometry, complete

Neurologist or Otolaryngologist

Audiologist

92557

Comprehensive hearing test

Neurologist or Otolaryngologist

Audiologist

92558

Evoked auditory test qual

Neurologist or Otolaryngologist

Audiologist

92562

Loudness balance test

Neurologist or Otolaryngologist

Audiologist

92563

Tone decay hearing test

Neurologist or Otolaryngologist

Audiologist

92565

Stenger test, pure tone

Neurologist or Otolaryngologist

Audiologist

92567

Tympanometry

Neurologist or Otolaryngologist

Audiologist

92568

Acoustic refl threshold tst

Neurologist or Otolaryngologist

Audiologist

92570

Acoustic immittance testing

Neurologist or Otolaryngologist

Audiologist

92571

Filtered speech hearing test

Neurologist or Otolaryngologist

Audiologist

92572

Staggered spondaic word test

Neurologist or Otolaryngologist

Audiologist

92575

Sensorineural acuity test

Neurologist or Otolaryngologist

Audiologist

92576

Synthetic sentence test

Neurologist or Otolaryngologist

Audiologist

92577

Stenger test, speech

Neurologist or Otolaryngologist

Audiologist

92579

Visual audiometry (vra)

Neurologist or Otolaryngologist

Audiologist

92582

Conditioning play audiometry

Neurologist or Otolaryngologist

Audiologist

92583

Select picture audiometry

Neurologist or Otolaryngologist

Audiologist

92584

Electrocochleography

Neurologist or Otolaryngologist

Audiologist

92587

Evoked auditory test limited

Neurologist or Otolaryngologist

Audiologist

92588

Evoked auditory test complete

Neurologist or Otolaryngologist

Audiologist

92596

Ear protector evaluation

Neurologist or Otolaryngologist

Audiologist

92651

Aep hearing status deter i&r

Neurologist or Otolaryngologist

Audiologist

92652

Aep thrshld est mlt freq i&r

Neurologist or Otolaryngologist

Audiologist

92653

Aep neurodiagnostic i&r

Neurologist or Otolaryngologist

Audiologist

93000

Electrocardiogram, complete

Internist or Cardiologist

CCI-CCT, RN, LPN, NCCT-NCET, NHA-CET

93005

Electrocardiogram, tracing

Internist or Cardiologist

CCI-CCT, RN, LPN, NCCT-NCET, NHA-CET

93010

Electrocardiogram report

Internist or Cardiologist

Physician Only Service

93015

Cardiovascular stress test

Internist or Cardiologist

RN/PA- ACLS certified

93016

Cardiovascular stress test

Internist or Cardiologist

RN/PA - ACLS certified

93017

Cardiovascular stress test

Internist or Cardiologist

RN/PA- ACLS certified

93018

Cardiovascular stress test

Internist or Cardiologist

Physician Only Service

93024

Cardiac drug stress test

Internist or Cardiologist

RN PA- ACLS certified

93025

Microvolt t-wave assess

Internist or Cardiologist

RN PA- ACLS certified

93040

Rhythm ECG with report

Internist or Cardiologist

CCI-CCT, RN, LPN, NCCT-NCET, NHA-CET

93041

Rhythm ECG, tracing

Internist or Cardiologist

CCI-CCT, RN, LPN, NCCT-NCET, NHA-CET

93042

Rhythm ECG, report

Internist or Cardiologist

Physician Only Service

93224

ECG monit/reprt up to 48 hrs

Cardiologist

CCI-CCT, RN, LPN, Paramedic

93225

ECG monit/reprt up to 48 hrs

Cardiologist

CCI-CCT, RN, LPN, Paramedic

93226

ECG monit/reprt up to 48 hrs

Cardiologist

CCI-CCT, RN, LPN, Paramedic

93227

ECG monit/reprt up to 48 hrs

Cardiologist

Physician Only Service

93228

Remote 30 day ECG rev/report

Cardiologist

RN, LPN, CCI-CCT, Paramedic

93229

Remote 30 day ECG tech supp

Cardiologist

RN, LPN, CCI-CCT

93241

Ext ecg>48hr<7d rec scan a/r

Cardiologist

Physician Only Service

93242

Ext ecg>48hr<7d recording

Cardiologist

RN, LPN, CCI-CCT

93243

Ext ecg>48hr<7d scan a/r

Cardiologist

Physician Only Service

93244

Ext ecg>48hr<7d rev&interpj

Cardiologist

RN, LPN, CCI-CCT

93245

Ext ecg>7d<15d rec scan a/r

Cardiologist

Physician Only Service

93246

Ext ecg>7d<15d recording

Cardiologist

RN, LPN, CCI-CCT

93247

Ext ecg>7d<15d scan a/r

Cardiologist

Physician Only Service

93248

Ext ecg>7d<15d rev&interpj

Cardiologist

RN, LPN, CCI-CCT, NCCT-NCET, NHA-CET

93260

Prgrmg dev eval impltbl sys

Cardiologist

RN, LPN, CCI-CCT, Paramedic, NCCT-NCET, NHA-CET

93261

Interrogate subq defib

Cardiologist

RN, LPN, CCI-CCT, Paramedic, NCCT-NCET, NHA-CET

93264

Rem mntr wrls p-art prs snr

Cardiologist

RN, CCI-CCT, NCCT-NCET, NHA-CET

93268

ECG record/review

Cardiologist

RN, LPN, CCI-CCT, Paramedic, NCCT-NCET, NHA-CET

93270

Remote 30 day ECG rev/report

Cardiologist

RN, LPN, CCI-CCT, Paramedic, NCCT-NCET, NHA-CET

93271

ECG/monitoring and analysis

Cardiologist

RN, LPN, CCI-CCT, Paramedic, NCCT-NCET, NHA-CET

93272

ECG/review interpret only

Cardiologist

Physician Only Service

93278

ECG/signal-averaged

Cardiologist

CCI-CCT, RN, LPN, NCCT-NCET, NHA-CET

93279

Prgrmg dev eval pm/ldls pm

Cardiologist

RN, CCI-CCT, NCCT-NCET, NHA-CET

93280

PM device progr eval dual

Cardiologist

RN, CCI-CCT, NCCT-NCET, NHA-CET

93281

PM device progr eval multi

Cardiologist

RN, CCI-CCT, NCCT-NCET, NHA-CET

93282

Prgrmg eval implantable dfb

Cardiologist

RN, CCI-CCT, NCCT-NCET, NHA-CET

93283

Prgrmg eval implantable dfb

Cardiologist

RN, CCI-CCT, NCCT-NCET, NHA-CET

93284

Prgrmg eval implantable dfb

Cardiologist

RN, CCI-CCT, NCCT-NCET, NHA-CET

93285

Prgrmg dev eval scrms ip

Cardiologist

RN, CCI-CCT, NCCT-NCET, NHA-CET

93288

Interrog evl pm/ldls pm ip

Cardiologist

RN, CCI-CCT, NCCT-NCET, NHA-CET

93289

Interrog device eval heart

Cardiologist

RN, CCI-CCT, NCCT-NCET, NHA-CET

93290

Interrog dev eval icpms ip

Cardiologist

RN, CCI-CCT, NCCT-NCET, NHA-CET

93291

Interrog dev eval scrms ip

Cardiologist

RN, CCI-CCT, NCCT-NCET, NHA-CET

93292

WCD device interrogate

Cardiologist

RN, CCI-CCT, NCCT-NCET, NHA-CET

93293

PM phone r-strip device eval

Cardiologist

RN, CCI-CCT, NCCT-NCET, NHA-CET

93294

Rem interrog evl pm/ldls pm

Cardiologist

RN, CCI-CCT, NCCT-NCET, NHA-CET

93295

Dev interrog remote 1/2/mlt

Cardiologist

RN, CCI-CCT, NCCT-NCET, NHA-CET

93296

Rem interrog evl pm/ids

Cardiologist

RN, CCI-CCT, NCCT-NCET, NHA-CET

93297

Rem interrog dev eval icpms

Cardiologist

RN, CCI-CCT, NCCT-NCET, NHA-CET

93298

Rem interrog dev eval scrms

Cardiologist

RN, CCI-CCT, NCCT-NCET, NHA-CET

93303

Echo transthoracic

Cardiologist

ARDMS-RDCS, CCI: RCS

93304

Echo transthoracic

Cardiologist

ARDMS-RDCS; CCI: RCS

93306

TTE w/doppler complete

Cardiologist

ARDMS-RDCS, CCI: RCS

93307

TTE w/o doppler complete

Cardiologist

ARDMS-RDCS; CCI: RCS

93308

TTE F/U or lmtd

Cardiologist

ARDMS-RDCS; CCI: RCS

93312

Echo transesophageal

Cardiologist

Physician only service

93313

Echo transesophageal

Cardiologist

Physician only service

93314

Echo transesophageal

Cardiologist

Physician only service

93315

Echo transesophageal

Cardiologist

Physician only service

93316

Echo transesophageal

Cardiologist

Physician only service

93317

Echo transesophageal

Cardiologist

Physician only service

93318

Echo transesophageal intraop

Cardiologist

Physician only service

93319

3D echocardiographic imaging and post processing

Cardiologist

ARDMS-RDCS, CCI: RCS

93320

Doppler echo exam, heart

Cardiologist

Credentialed by ARDMS-RDCS,

93321

Doppler echo exam, heart

Cardiologist

Credentialed by ARDMS RDCS,

93325

Doppler color flow add-on

Cardiologist

Credentialed by ARDMS RDCS,

93350

Stress TTE only

Cardiologist

ARDMS RDCS, CCI: RCS

93351

Stress TTE complete

Cardiologist

ARDMS: RDCS: CCI: RCS

93352

Admin ECG contrast agent

Cardiologist

ARDMS: RDCS: CCI: RCS

93356

Myocrd strain img spckl trck

Cardiologist

Credentialed by ARDMS-RDCS

93600

Bundle of His recording

Cardiologist

Physician only service

93602

Intra-atrial recording

Cardiologist

Physician only service

93603

Right ventricular recording

Cardiologist

Physician only service

93609

Map tachycardia, add-on

Cardiologist

Physician only service

93610

Intra-atrial pacing

Cardiologist

Physician only service

93612

Intraventricular pacing

Cardiologist

Physician only service

93613

Electrophys map 3D, add-on

Cardiologist

Physician only service

93615

Esophageal recording

Cardiologist

Physician only service

93616

Esophageal recording

Cardiologist

Physician only service

93618

Heart rhythm pacing

Cardiologist

Physician only service

93619

Electrophysiology evaluation

Cardiologist

Physician only service

93620

Electrophysiology evaluation

Cardiologist

Physician only service

93621

Electrophysiology evaluation

Cardiologist

Physician only service

93622

Electrophysiology evaluation

Cardiologist

Physician only service

93623

Stimulation, pacing heart

Cardiologist

Physician only service

93624

Electrophysiologic study

Cardiologist

Physician only service

93631

Heart pacing, mapping

Cardiologist

Physician only service

93640

Evaluation heart device

Cardiologist

Physician only service

93641

Electrophysiology evaluation

Cardiologist

Physician only service

93642

Electrophysiology evaluation

Cardiologist

Physician only service

93644

Electrophysiological eval SQ def

Cardiologist

Physician only service

93660

Tilt table evaluation

Cardiologist

RN, or CCI-CCT, NCCT-NCET, NHA-CET

93662

Intracardiac ECG (ice)

Cardiologist

Physician only service

93701

Bioimpedance, thoracic

Cardiologist

Physician only service

93724

Analyze pacemaker system

Cardiologist

Physician only service

93740

Temperature gradient studies

Cardiologist

RN

93745

Set-up cardiovert-defibrill

Cardiologist

RN

93750

Interrogation of ventricular assist device (VAD)

Cardiologist

RN

93770

Measure venous pressure

Cardiologist

RN

93784

Ambl bp mntr w/software

Cardiologist

RN

93786

Ambl bp mntr w/sw rec only

Cardiologist

RN

93788

Ambl bp mntr w/sw a/r

Cardiologist

RN

93790

Ambl bp mntr w/sw i&r

Cardiologist

Physician only service

93880

Extracranial bilat study

Radiologist, Neurologist or Cardiologist, Vascular Surgeon

Credentialed by ARDMS -RDMS, RVT or ARRT- RS

93882

Extracranial uni/ltd study

Radiologist, Neurologist or Cardiologist, Vascular Surgeon

Credentialed by ARDMS -RDMS, RVT or ARRT- RS

93886

Intracranial complete study

Radiologist, Neurologist or Cardiologist, Vascular Surgeon

Credentialed by ARDMS -RDMS, RVT or ARRT- RS

93888

Intracranial limited study

Radiologist, Neurologist or Cardiologist, Vascular Surgeon

Credentialed by ARDMS -RDMS, RVT or ARRT- RS

93890

Tcd, vasoreactivity study

Radiologist, Neurologist or Cardiologist, Vascular Surgeon

Credentialed by ARDMS -RDMS, RVT or ARRT- RS

93892

Tcd, emboli detect w/o inj

Radiologist, Neurologist or Cardiologist, Vascular Surgeon

Credentialed by ARDMS -RDMS, RVT or ARRT- RS

93893

Tcd, emboli detect w/inj

Radiologist, Neurologist or Cardiologist, Vascular Surgeon

Credentialed by ARDMS -RDMS, RVT or ARRT- RS

93895

Quantitative carotid evaluation

Radiologist, Neurologist or Cardiologist, Vascular Surgeon

Credentialed by ARDMS -RDMS, RVT or ARRT- RS

93922

Upr/l xtremity art 2 levels

Radiologist, Cardiologist, Vascular Surgeon

Credentialed by ARDMS -RDMS, RVT or ARRT- RS, CCI-RVS

93923

Upr/l xtr art stdy 3+ lvls

Radiologist , Cardiologist, Vascular Surgeon

Credentialed by ARDMS -RDMS, RVT or ARRT- RS, CCI-RVS

93924

Lwr xtr vasc stdy bilat

Radiologist, Cardiologist, Vascular Surgeon

Credentialed by ARDMS -RDMS, RVT or ARRT- RS, CCI-RVS

93925

Lower extremity study

Radiologist, Cardiologist Vascular Surgeon

Credentialed by ARDMS -RDMS, RVT or ARRT- RS, CCI-RVS

93926

Lower extremity study

Radiologist, Cardiologist, Vascular Surgeon

Credentialed by ARDMS -RDMS, RVT or ARRT- RS, CCI-RVS

93930

Upper extremity study

Radiologist, Cardiologist, Vascular Surgeon

Credentialed by ARDMS -RDMS, RVT or ARRT- RS, CCI-RVS

93931

Upper extremity study

Radiologist, Cardiologist, Vascular Surgeon

Credentialed by ARDMS -RDMS, RVT or ARRT- RS, CCI-RVS

93970

Extremity study

Radiologist, Cardiologist, Vascular Surgeon

Credentialed by ARDMS -RDMS, RVT or ARRT- RS, CCI-RVS

93971

Extremity study

Radiologist, Cardiologist, Vascular Surgeon

Credentialed by ARDMS -RDMS, RVT or ARRT- RS, CCI-RVS

93975

Vascular study

Radiologist, Vascular Surgeon

Credentialed by ARDMS -RDMS, RVT or ARRT- RS Credentialed by ARDMS- RVT, CCI-RVS

93976

Vascular study

Radiologist , Vascular Surgeon

Credentialed by ARDMS -RDMS, RVT or ARRT- RS, CCI-RVS

93978

Vascular study

Radiologist , Vascular Surgeon

Credentialed by ARDMS -RDMS, RVT or ARRT- RS, CCI-RVS

93979

Vascular study

Radiologist, Vascular Surgeon

Credentialed by ARDMS -RDMS, RVT or ARRT- RS, CCI-RVS

93980

Penile vascular study

Radiologist or Urologist, Vascular Surgeon

Credentialed by ARDMS -RDMS, RVT or ARRT- RS, CCI-RVS

93981

Penile vascular study

Radiologist or Urologist, Vascular Surgeon

Credentialed by ARDMS -RDMS, RVT or ARRT- RS, CCI-RVS

93985

Dup-scan hemo compl bi std

Radiologist, Vascular Surgeon

Credentialed by ARDMS -RDMS, RVT or ARRT- RS, CCI-RVS

93986

Dup-scan hemo compl uni std

Radiologist, Vascular Surgeon

Credentialed by ARDMS -RDMS, RVT or ARRT- RS, CCI-RVS

93990

Doppler flow testing

Radiologist, Vascular Surgeon

Credentialed by ARDMS -RDMS, RVT or ARRT- RS, CCI-RVS

94010

Breathing capacity test

Pulmonologist

Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience

94014

Patient recorded spirometry

Pulmonologist

Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience

94015

Patient recorded spirometry

Pulmonologist

Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience

94016

Review patient spirometry

Pulmonologist

Physician only service

94060

Evaluation of wheezing

Pulmonologist

Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience

94070

Evaluation of wheezing

Pulmonologist

Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience

94150

Vital capacity test

Pulmonologist

Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience

94200

Lung function test (MBC/MVV)

Pulmonologist

Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience

94375

Respiratory flow volume loop

Pulmonologist

Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience

94450

Hypoxia response curve

Pulmonologist

Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience

94452

Hast w/report

Pulmonologist

Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience

94453

Hast w/oxygen titrate

Pulmonologist

Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience

94618

Pulmonary stress testing

Pulmonologist

Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience

94621

Cardiopulm exercise testing

Pulmonologist

Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience

94680

Exhaled air analysis, O2

Pulmonologist

Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience

94681

Exhaled air analysis, O2/CO2

Pulmonologist

Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience

94690

Exhaled air analysis

Pulmonologist

Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience

94726

Pulm funct tst plethysmograp

Pulmonologist

Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience

94727

Pulm function test by gas

Pulmonologist

Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience

94728

Airwy resist by oscillometry

Pulmonologist

Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience

94729

Co/membrane diffuse capacity

Pulmonologist

Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience

94760

Measure blood oxygen level

Pulmonologist

Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience

94761

Measure blood oxygen level

Pulmonologist

Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience

94762

Measure blood oxygen level

Pulmonologist

Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience

94772

Breath recording, infant

Pulmonologist

Credentialed by NBRC (CPFT, RPFT or RRT) or RN with relevant experience

95004

Percut allergy skin tests

Otolaryngologist/Allergy/ Immunology

RN

95017

Perq & icut allg test venoms

Otolaryngologist/Allergy/ Immunology

RN

95018

Perq&ic allg test drugs/biol

Otolaryngologist/Allergy/ Immunology

RN

95024

Inj.allergenic extracts for immed.rxn

Otolaryngologist/Allergy/ Immunology

RN

95027

Id allergy titrate-airborne

Otolaryngologist/Allergy/ Immunology

RN

95028

Id allergy test-delayed type

Otolaryngologist/Allergy/ Immunology

RN

95044

Allergy patch tests

Otolaryngologist/Allergy/ Immunology, Dermatology

RN

95052

Photo patch test

Otolaryngologist/Allergy/ Immunology, Dermatology

RN

95056

Photosensitivity tests

Otolaryngologist/Allergy/ Immunology, Dermatology

RN

95060

Eye allergy tests

Otolaryngologist/Allergy/ Immunology

Physician only service

95065

Nose allergy test

Otolaryngologist/Allergy/ Immunology

Physician only service

95070

Bronchial allergy tests

Allergy/Immunology Otolaryngologist

RN

95076

Ingest challenge ini 120 min

Allergy/Immunology Otolaryngologist

Physician only service

95079

Ingest challenge addl 60 min

 

Allergy/Immunology Otolaryngologist

Physician only service

95700

Eeg cont rec w/vid eeg tech

Neurologist

Credentialed by ABRET as R. EEG T

95705

Eeg w/o vid 2-12 hr unmntr

Neurologist

Credentialed by ABRET as R. EEG T

95706

Eeg wo vid 2-12hr intmt mntr

Neurologist

Credentialed by ABRET as R. EEG T

95707

Eeg w/o vid 2-12hr cont mntr

Neurologist

Credentialed by ABRET as R. EEG T

95708

Eeg wo vid ea 12-26hr unmntr

Neurologist

Credentialed by ABRET as R. EEG T

95709

Eeg w/o vid ea 12-26hr intmt

Neurologist

Credentialed by ABRET as R. EEG T

95710

Eeg w/o vid ea 12-26hr cont

Neurologist

Credentialed by ABRET as R. EEG T

95711

Veeg 2-12 hr unmonitored

Neurologist

Credentialed by ABRET as R. EEG T

95712

Veeg 2-12 hr intmt mntr

Neurologist

Credentialed by ABRET as R. EEG T

95713

Veeg 2-12 hr cont mntr

Neurologist

Credentialed by ABRET as R. EEG T

95714

Veeg ea 12-26 hr unmntr

Neurologist

Credentialed by ABRET as R. EEG T

95715

Veeg ea 12-26hr intmt mntr

Neurologist

Credentialed by ABRET as R. EEG T

95716

Veeg ea 12-26hr cont mntr

Neurologist

Credentialed by ABRET as R. EEG T

95717

Eeg phys/qhp 2-12 hr w/o vid

Neurologist

Credentialed by ABRET as R. EEG T

95718

Eeg phys/qhp 2-12 hr w/veeg

Neurologist

Credentialed by ABRET as R. EEG T

95719

Eeg phy/qhp ea incr w/o vid

Neurologist

Credentialed by ABRET as R. EEG T

95720

Eeg phy/qhp ea incr w/veeg

Neurologist

Credentialed by ABRET as R. EEG T

95721

Eeg phy/qhp>36<60 hr w/o vid

Neurologist

Credentialed by ABRET as R. EEG T

95722

Eeg phy/qhp>36<60 hr w/veeg

Neurologist

Credentialed by ABRET as R. EEG T

95723

Eeg phy/qhp>60<84 hr w/o vid

Neurologist

Credentialed by ABRET as R. EEG T

95724

Eeg phy/qhp>60<84 hr w/veeg

Neurologist

Credentialed by ABRET as R. EEG T

95725

Eeg phy/qhp>84 hr w/o vid

Neurologist

Credentialed by ABRET as R. EEG T

95726

Eeg phy/qhp>84 hr w/veeg

Neurologist

Credentialed by ABRET as R. EEG T

95782

Polysom <6 yrs 4/> paramtrs

MD/DO certified with (ABSM), or has a Sleep Certification issued by (ABIM), (ABFM), (ABP), (ABPN), (ABOto), (AOBNP), (AOBFP), (AOBIM), (AOBOO)

Registered Sleep Technologist (RST); Registered Polysomnographic Technologist (RPSGT); Certified Pulmonary Function Technologist (CPFT), Registered Pulmonary Function Technologist (RPFT), Certified Respiratory Therapist (CRT), Registered Respiratory Therapist (RRT)

95783

Polysom < 6 yrs cpap/bilvl

MD/DO certified with (ABSM), or has a Sleep Certification issued by (ABIM), (ABFM), (ABP), (ABPN), (ABOto), (AOBNP), (AOBFP), (AOBIM), (AOBOO)

Registered Sleep Technologist (RST); Registered Polysomnographic Technologist (RPSGT); Certified Pulmonary Function Technologist (CPFT), Registered Pulmonary Function Technologist (RPFT), Certified Respiratory Therapist (CRT), Registered Respiratory Therapist (RRT)

95800

Slp stdy unattended

*only used in a facility

MD/DO certified with (ABSM), or has a Sleep Certification issued by (ABIM), (ABFM), (ABP), (ABPN), (ABOto), (AOBNP), (AOBFP), (AOBIM), (AOBOO)

Registered Sleep Technologist (RST); Registered Polysomnographic Technologist (RPSGT); Certified Pulmonary Function Technologist (CPFT), Registered Pulmonary Function Technologist (RPFT), Certified Respiratory Therapist (CRT), Registered Respiratory Therapist (RRT)

95801

Slp stdy unatnd w/anal

*Only used in a facility

MD/DO certified with (ABSM), or has a Sleep Certification issued by (ABIM), (ABFM), (ABP), (ABPN), (ABOto), (AOBNP), (AOBFP), (AOBIM), (AOBOO)

Registered Sleep Technologist (RST); Registered Polysomnographic Technologist (RPSGT); Certified Pulmonary Function Technologist (CPFT), Registered Pulmonary Function Technologist (RPFT), Certified Respiratory Therapist (CRT), Registered Respiratory Therapist (RRT)

95805

Multiple sleep latency test

MD/DO certified with (ABSM), or has a Sleep Certification issued by (ABIM), (ABFM), (ABP), (ABPN), (ABOto), (AOBNP), (AOBFP), (AOBIM), (AOBOO)

Registered Sleep Technologist (RST); Registered Polysomnographic Technologist (RPSGT); Certified Pulmonary Function Technologist (CPFT), Registered Pulmonary Function Technologist (RPFT), Certified Respiratory Therapist (CRT), Registered Respiratory Therapist (RRT)

95806

Sleep study unatt&resp efft

*Only used in a facility

MD/DO certified with (ABSM), or has a Sleep Certification issued by (ABIM), (ABFM), (ABP), (ABPN), (ABOto), (AOBNP), (AOBFP), (AOBIM), (AOBOO)

Registered Sleep Technologist (RST); Registered Polysomnographic Technologist (RPSGT); Certified Pulmonary Function Technologist (CPFT), Registered Pulmonary Function Technologist (RPFT), Certified Respiratory Therapist (CRT), Registered Respiratory Therapist (RRT)

95807

Sleep study, attended

MD/DO certified with (ABSM), or has a Sleep Certification issued by (ABIM), (ABFM), (ABP), (ABPN), (ABOto), (AOBNP), (AOBFP), (AOBIM), (AOBOO)

Registered Sleep Technologist (RST); Registered Polysomnographic Technologist (RPSGT); Certified Pulmonary Function Technologist (CPFT), Registered Pulmonary Function Technologist (RPFT), Certified Respiratory Therapist (CRT), Registered Respiratory Therapist (RRT)

95808

Polysom any age 1-3> param

MD/DO certified with (ABSM), or has a Sleep Certification issued by (ABIM), (ABFM), (ABP), (ABPN), (ABOto), (AOBNP), (AOBFP), (AOBIM), (AOBOO)

Registered Sleep Technologist (RST); Registered Polysomnographic Technologist (RPSGT); Certified Pulmonary Function Technologist (CPFT), Registered Pulmonary Function Technologist (RPFT), Certified Respiratory Therapist (CRT), Registered Respiratory Therapist (RRT)

95810

Polysom 6/> yrs 4/> param

MD/DO certified with (ABSM), or has a Sleep Certification issued by (ABIM), (ABFM), (ABP), (ABPN), (ABOto), (AOBNP), (AOBFP), (AOBIM), (AOBOO)

Registered Sleep Technologist (RST); Registered Polysomnographic Technologist (RPSGT); Certified Pulmonary Function Technologist (CPFT), Registered Pulmonary Function Technologist (RPFT), Certified Respiratory Therapist (CRT), Registered Respiratory Therapist (RRT)

95811

Polysom 6/>yrs cpap 4/> parm

MD/DO certified with (ABSM), or has a Sleep Certification issued by (ABIM), (ABFM), (ABP), (ABPN), (ABOto), (AOBNP), (AOBFP), (AOBIM), (AOBOO)

Registered Sleep Technologist (RST); Registered Polysomnographic Technologist (RPSGT); Certified Pulmonary Function Technologist (CPFT), Registered Pulmonary Function Technologist (RPFT), Certified Respiratory Therapist (CRT), Registered Respiratory Therapist (RRT)

95812

EEG, 41-60 minutes

Neurologist

Credentialed by ABRET as R. EEG T

95813

Eeg extnd mntr 61-119 min

Neurologist

Credentialed by ABRET as R. EEG T

95816

EEG, awake and drowsy

Neurologist

Credentialed by ABRET as R. EEG T

95819

EEG, awake and asleep

Neurologist

Credentialed by ABRET as R. EEG T

95822

EEG, coma or sleep only

Neurologist

Credentialed by ABRET as R. EEG T

95824

EEG, cerebral death only

Neurologist

Credentialed by ABRET as R. EEG T

95830

Insert electrodes for EEG

Neurologist

Physician only service

95836

Ecog impltd brn npgt <30 d

Neurologist

Credentialed by ABRET as R. EEG T

95860

Muscle test, one limb

Neurologist –Physical Medicine & Rehab

Procedure must be performed by PT w/ ABPTS

95861

Muscle test, 2 limbs

Neurologist –Physical Medicine & Rehab

Procedure must be performed by PT w/ ABPTS

95863

Muscle test, 3 limbs

Neurologist –Physical Medicine & Rehab

Procedure must be performed by PT w/ ABPTS

95864

Muscle test, 4 limbs

Neurologist –Physical Medicine & Rehab

Procedure must be performed by PT w/ ABPTS

95867

Muscle test cran nerv unilat

Neurologist –Physical Medicine & Rehab

Procedure must be performed by PT w/ ABPTS

95868

Muscle test cran nerve bilat

Neurologist –Physical Medicine & Rehab

Procedure must be performed by PT w/ ABPTS

95869

Muscle test, thor paraspinal

Neurologist –Physical Medicine & Rehab

Procedure must be performed by PT w/ ABPTS

95870

Muscle test, nonparaspinal

Neurologist –Physical Medicine & Rehab

Procedure must be performed by PT w/ ABPTS

95872

Muscle test, one fiber

Neurologist –Physical Medicine & Rehab

Procedure must be performed by PT w/ ABPTS

95875

Limb exercise test

Neurologist –Physical Medicine & Rehab Neurologist

Physician only service

95885

Musc tst done w/nerv tst lim

Neurologist –Physical Medicine & Rehab

Procedure must be performed by PT w/ ABPTS

95886

Musc test done w/n test comp

Neurologist –Physical Medicine & Rehab

Procedure must be performed by PT w/ ABPTS

95887

Musc tst done w/n tst nonext

Neurologist –Physical Medicine & Rehab

Procedure must be performed by PT w/ ABPTS

95905

Motor &/sens NCV test

Neurologist –Physical Medicine & Rehab

Registered evoked potential technologist (R.EPT)

95907

Nvr cndj tst 1-2 studies

Neurologist –Physical Medicine & Rehab

Registered evoked potential technologist (R.EPT)

95908

Nvr cndj tst 3-4 studies

Neurologist –Physical Medicine & Rehab

Registered evoked potential technologist (R.EPT)

95909

Nvr cndj tst 5-6 studies

Neurologist –Physical Medicine & Rehab

Registered evoked potential technologist (R.EPT)

95910

Nvr cndj tst 7-8 studies

Neurologist –Physical Medicine & Rehab

Registered evoked potential technologist (R.EPT)

95911

Nvr cndj tst 9-10 studies

Neurologist –Physical Medicine & Rehab

Registered evoked potential technologist (R.EPT)

95912

Nvr cndj tst 11-12 studies

Neurologist –Physical Medicine & Rehab

Registered evoked potential technologist (R.EPT)

95913

Nvr cndj tst 13/> studies

Neurologist –Physical Medicine & Rehab

Registered evoked potential technologist (R.EPT)

95921

Autonomic parasym testing

Neurologist –Physical Medicine & Rehab t

Credentialed by ABRET as R. EPT

95922

Autonomic testing sympathetic > 5 minutes tilt

Neurologist –Physical Medicine & Rehab

Credentialed by ABRET as R. EPT

95923

Sudomotor plus

Neurologist –Physical Medicine & Rehab

Credentialed by ABRET as R. EPT

95924

Ans parasymp & symp w/tilt

Neurologist –Physical Medicine & Rehab

Credentialed by ABRET as R. EPT

95925

Somatosensory testing

Neurologist

Credentialed by ABRET as R. EPT

95926

Somatosensory testing

Neurologist

Credentialed by ABRET as R. EPT

95927

Somatosensory testing

Neurologist

Credentialed by ABRET as R. EPT

95928

C motor evoked, uppr limbs

Neurologist

Credentialed by ABRET as R. EPT

95929

C motor evoked, lwr limbs

Neurologist

Credentialed by ABRET as R. EPT

95930

Visual ep test cns w/i&r

Neurologist

Credentialed by ABRET as R. EPT

95933

Blink reflex test

Neurologist –Physical Medicine & Rehab

PT w/ ABPTS

95937

Neuromuscular junction test

Neurologist –

PT w/ ABPTS

95938

Somatosensory testing

Neurologist –Physical Medicine & Rehab

PT w/ ABPTS

95939

C motor evoked upr&lwer limbs

Neurologist –Physical Medicine & Rehab

PT w/ ABPTS

95954

EEG monitoring/giving drugs

Neurologist

Physician only service

95957

EEG digital analysis

Neurologist

Credentialed by ABRET as R. EEG T

95958

EEG monitoring/function test

Neurologist

Physician only service

95976

Alys smpl cn npgt prgrmg

Neurologist

Physician only service

95977

Alys cplx cn npgt prgrmg

Neurologist

Physician only service

95983

Alys brn npgt prgrmg 15 min

Neurologist

Physician only service

95984

Alys brn npgt prgrmg addl 15

Neurologist

Physician only service

96000

Motion analysis, video/3D

Neurologist

PT w/ ABPTS

96001

Motion test w/ft press meas

Neurologist

PT w/ ABPTS

96002

Dynamic surface EMG

Neurologist

Physician Only Service

96003

Dynamic fine wire EMG

Neurologist

Physician Only Service

96004

Phys review & interpretation of motion tests

Neurologist

Physician only service

G0248

Demonstrate use home inr mon

Physician: General Supervision

Registered Nurse

G0249

Provide inr test mater/equip

Physician: General Supervision

Demonstrates Proficiency

G0398

Home sleep test/type 2 porta

MD/DO certified with (ABSM), or has a Sleep Certification issued by (ABIM), (ABFM), (ABP), (ABPN), (ABOto), (AOBNP), (AOBFP), (AOBIM), (AOBOO)

Registered Sleep Technologist (RST); Registered Polysomnographic Technologist (RPSGT); Certified Pulmonary Function Technologist (CPFT), Registered Pulmonary Function Technologist (RPFT), Certified Respiratory Therapist (CRT), Registered Respiratory Therapist (RRT)

G0399

Home sleep test/type 3 porta

MD/DO certified with (ABSM), or Sleep Certification issued by (ABIM), (ABFM), (ABP), (ABPN), (ABOto), (AOBNP), (AOBFP), (AOBIM), (AOBOO)

Registered Sleep Technologist (RST); Registered Polysomnographic Technologist (RPSGT); Certified Pulmonary Function Technologist (CPFT), Registered Pulmonary Function Technologist (RPFT), Certified Respiratory Therapist (CRT), Registered Respiratory Therapist (RRT)

G0400

Home sleep test/type 4 porta

MD/DO certified with (ABSM), or has a Sleep Certification issued by (ABIM), (ABFM), (ABP), (ABPN), (ABOto), (AOBNP), (AOBFP), (AOBIM), (AOBOO)

Registered Sleep Technologist (RST); Registered Polysomnographic Technologist (RPSGT); Certified Pulmonary Function Technologist (CPFT), Registered Pulmonary Function Technologist (RPFT), Certified Respiratory Therapist (CRT), Registered Respiratory Therapist (RRT)

Key for Abbreviations used in the table:

The physician (MD/DO) performing the service must meet the criteria in our Polysomnography and OtherSleep Studies LCD (L36839)

Physician and Technician Requirements for Sleep Studies and Polysomnography Testing:

  1. The physician performing the service must meet 1 of the following:

    1. be a diplomate of the American Board of Sleep Medicine (ABSM);
      OR
    2. has a Sleep Certification issued by ONE of the following Boards:
      American Board of Internal Medicine (ABIM),
      American Board of Family Medicine (ABFM),
      American Board of Pediatrics (ABP),
      American Board of Psychiatry and Neurology (ABPN),
      American Board of Otolaryngology (ABOto),
      American Osteopathic Board of Neurology and Psychiatry (AOBNP),
      American Osteopathic Board of Family Medicine, (AOBFP)
      American Osteopathic Board of Internal Medicine, (AOBIM)
      American Osteopathic Board of Ophthalmology and Otorhinolaryngology (AOBOO);
      OR
    3. be an active physician staff member of a credentialed sleep center or laboratory that have active physician staff members meeting the criteria above in a or b.
  2. Technician Credentials
    The technician performing the service must meet 1 of the following:
    • American Board of Sleep Medicine (ABSM),
      Registered Sleep Technologist (RST);
    • Board of Registered Polysomnographic Technologists (BRPT),
      Registered Polysomnographic Technologist (RPSGT);
    • National Board for Respiratory Care (NBRC)
      Certified Pulmonary Function Technologist (CPFT)
      Registered Pulmonary Function Technologist (RPFT)
      Certified Respiratory Therapist (CRT)
      Registered Respiratory Therapist (RRT)

Sleep Center or Laboratory Credentials (this is any site or place of service other than patient’s home where sleep studies or recordings are performed)

  • The sleep facility credentials must be from the American Academy of Sleep Medicine (AASM), inpatient or outpatient;
    OR
  • The Joint Commission (formerly the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) sleep specific credentials for Ambulatory care sleep centers;
    OR
  • Accreditation Commission for Health Care (ACHC)

American Board of Registration of electroencephalographic and evoked potential technologists (ABRET)
http://abret.org/
Registered Electroencephalographic technologist (R.EEG T)
Registered evoked potential technologist (R.EPT)

American Board of Sleep Medicine (ABSM)
http://absm.org/
Registered Sleep Technologist (RST)

American Registry of Diagnostic Medical Sonographers (ARDMS)
https://www.ardms.org/
Registered Diagnostic Medical Sonographer (RDMS)
Registered Diagnostic Cardiac Sonographer (RDCS)
Registered Vascular Technologist (RVT)

American Registry of Magnetic Resonance Imaging Technologist (ARMRIT)
http://www.armrit.org/
Registered Magnetic Resonance Imaging Technologist -RT-MR

American Registry of Radiologic Technologists (ARRT)
https://www.arrt.org/
Certified Radiologic Technologist -Bone Densitometry (CRT-BD)
Certified Radiologic Technologist –Sonography (CRT-S)
Certified Radiologic Technologist –Vascular Sonography (CRT-VS)
Certified Radiologic Technologist-Radiographer (CRT-R)
Certified Radiologic Technologist -Computed Tomography (CRT-CT)
Certified Radiologic Technologist -Magnetic Resonance Imaging (CRT-MR)
Certified Radiologic Technologist- Radiation Therapy (CRT-T);
Certified Radiologic Technologist-Nuclear Medicine (CRT-N).

Board of Registered Polysomnographic Technologists (BRPT)
http://www.brpt.org/
Registered Polysomnographic Technologist (RPSGT)

Cardiovascular Credentialing International (CCI)
http://www.cci-online.org/
Certified Cardiographic Technician (CCT)
Certified Cardiac Sonographer (RCS)
Registered Vascular Specialist (RVS)

International Society for Clinical Densitometry (ISCD)
http://www.iscd.org/
Certified Densitometry Technologist (CDT)
Certified Bone Densitometry Technologist (CBDT)

National Board for Respiratory Care (NBRC)
http://www.nbrc.org/
Certified Pulmonary Function Technologist (CPFT)
Registered Pulmonary Function Technologist (RPFT)
Certified Respiratory Therapist (CRT)
Registered Respiratory Therapist (RRT)

Joint Commission on Allied Health personnel in Ophthalmology (JCAHPO)
http://www.jcahpo.org/
Joint Commission on Allied Health personnel in Ophthalmology (JCAHPO) offers 3 levels of certification:
Certified Ophthalmic Assistant (COA)
Certified Ophthalmic Technician (COT®) (Intermediate Level)
Certified Ophthalmic Medical Technologist (COMT®) (Advanced Level)

Nuclear Medicine Technologist Certification Board
http://www.nmtcb.org/
Certified Nuclear Medicine Technologist (CNMT)
Nuclear cardiology specialty exam
Pet Exams

National Center for Competency Testing (NCCT)
National Certified ECG Technician (NCET)
http://www.ncctinc.com/

National Healthcareer Association (NHA)
Certified EKG Technician (CET)
https://www.nhanow.com/

Response To Comments

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1
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Coding 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.

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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.

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Coding Table Information

Excluded CPT/HCPCS Codes - Table Format
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Non-Excluded CPT/HCPCS Ended Codes - Table Format
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Revision History Information

Revision History Date Revision History Number Revision History Explanation
02/26/2026 R31

Posted 02/26/2026: Under CPT/HCPCS codes, deleted 0501T, 0502T, 0503T, and 0504T. This change was effective 01/01/2024. Under CPT/HCPCS codes added 70471. This change has an effective date of 01/01/2026.
01/01/2026 R30

Posted 01/15/2026: Under CPT/HCPCS codes, added 76014, 76015, 76016, 76017, 76018, and 76019 as they were deleted in error. 
01/01/2026 R29

Posted 01/01/2026: Biennial review completed 11/14/2025. Minor grammatical changes made with no changes to coverage.
01/01/2025 R28

Posted 01/30/2025: Under CPT/HCPCS codes, added 76014, 76015, 76016, 76017, 76018, and 76019. These changes are due to the 2025 annual CPT/HCPCS code updates and will become effective 01/01/2025.
01/01/2024 R27

Posted 04/25/2024: CPT code G2066 was deleted due to the 2024 Annual/Q1 CPT/HCPCS Code Updates. This revision is effective 01/01/2024.
10/26/2023 R26

Posted 10/26/2023: Biannual review completed with no change in coverage.
06/29/2023 R25

Posted 06/29/2023: CPT codes 0501T, 0502T, 0503T, and 0504T were added along with applicable supervising physician qualification requirements and technician qualification requirements.
09/01/2022 R24

Posted 09/01/2022- Added CPT 71271 based on the National Coverage Analysis (NCA) associated with NCD 210.14 Reconsideration, Screening for Lung Cancer with Low Dose Computed Tomography (LDCT). This update is effective 02/10/2022.
03/31/2022 R23

Posted 03/31/2022-Added National Healthcareer Association (NHA)-Certified EKG Technician (CET). Added NCCT-NCET, NHA-CET to technician qualifications for CPT codes 93000, 93005, 93040, 93041, 93248, 93260, 93261, 93264, 93268, 93270, 93271, 93278-93285, 93288-93298, 93660, G2066. Added RN, PA-ACLS certified to technician qualifications for CPT code 93024.
01/27/2022 R22

01/27/2022-Added 51798 Board Certified (ABMS) Urologist or Radiologist &Urology or OB/GYN Personally Trained Staff; CRT-R. Removed duplicate line of 75573 from the table.
01/01/2022 R21

12/30/2021- CPT/HCPCS update-added: 77089, 77090, 77091 & 93319. Removed deleted codes: 72275, 76101, 76102, 92561, 92564, 95943. Description change: 75573. Removed “2021 CPT/HCPCS Annual code update: 0295T, 0296T, 0297T, and 0298T deleted. Effective 01/01/2021. Please refer to LCD L34636 Electrocardiographic (EKG or ECG) Monitoring (Holter or Real-Time Monitoring) and A57476 Billing and Coding: Electrocardiographic (EKG or ECG) Monitoring (Holter or Real-Time Monitoring)” from the body of the document. Review completed 11/16/2021.
01/01/2021 R20

12/31/2020 CPT/HCPCS annual update completed. Description changes: 71250, 71260, 71270, 74425, 76513, 92227, and 92228. Deleted: 76970, 78135, 92585, 92586, 94250, 94400, 94750, 94770, 95071, 0295T, 0296T, 0297T, and 0298T. Added: 92229, 92517, 92518, 92519, 92651, 92652, 92653, 93241, 93242, 93243, 93244, 93245, 93246, 93247, and 93248. 2021 CPT/HCPCS Annual code update: 0295T, 0296T, 0297T, and 0298T deleted. Effective 01/01/2021. Please refer to LCD L34636 Electrocardiographic (EKG or ECG) Monitoring (Holter or Real-Time Monitoring) and A57476 Billing and Coding: Electrocardiographic (EKG or ECG) Monitoring (Holter or Real-Time Monitoring). Please refer to A54953 Independent Diagnostic Testing Facilities – physician supervision and technician requirements.
08/27/2020 R19

08/27/2020 Added CPT Codes G0248 and G0249. Please see Article for Supervising Physician Qualification Requirements: Physician: General Supervision and Technician Qualifications: Registered Nurse due to IDTF request and supported by 42 Code of Federal Regulations (C.F.R.) section 410.33(g).
04/30/2020 R18

04/30/2020: Added: CPT Codes 0295T, 0296T, 0297T and 0298T. Please see Article for Supervising Physician Qualification Requirements and Technician Qualifications. Please refer to LCD L34636 Electrocardiographic (EKG or ECG) Monitoring (Holter or Real-Time Monitoring) and A57476 Billing and Coding: Electrocardiographic (EKG or ECG) Monitoring (Holter or Real-Time Monitoring). The physician (MD/DO) performing the service must meet all criteria in this LCD and Billing and Coding Article. All of the procedure codes are subject to Medicare rules and regulations, applicable Local Coverage Decisions (LCD’s), and medical necessity.
01/01/2020 R17

03/26/2020 HCPCS code G2066 added with Supervising Physician Qualification Requirements: Board Certified (ABMS) Cardiologist and Technician Qualification: State Licensed: RN or Paramedic, or Credentialed by CCI: CCT; Certified Rhythm Analysis Technician (CRAT) due to IDTF request and supported by Federal Registry: Vol 84, No. 221/Friday, November 15, 2019/Rules and Regulations Effective 01/01/2020.
01/01/2020 R16

02/27/2020 CPT codes 95700, 95705, 95706, and 95707 descriptions changed from long to short. Added CPT codes 95708-95726 with Supervising Physician Qualification Requirements: Neurologist and
Technician Qualification: Credentialed by ABRET as R. EEG T. Effective 01/01/2020.
01/01/2020 R15

12/26/2019 Content has been moved to the new template. CPT 27369 included per IDTF request. CPT/HCPCS annual update: Description changes: 74022, 74210, 74220, 74230, 74240, 74246, 74250, 74251, 74270, 74280, 78459, 78491, 78800, 78801, 78802, 78803, 78804, 92548, 93784, 93786, 93788, 93790, 94728, and 95813; Deleted codes: 74241, 74245, 74247, 74249, 74260, 76930, 78205, 78206, 78320, 78607, 78647, 78710, 78805, 78806, 78807, 92225, 92226, 93299, 95827, 95950, 95951, 95953, and 95956; Added codes: 74221, 74248, 78429, 78430, 78431, 78432, 78433, 78434, 78830, 78831, 78832, 78835, 92201, 92202, 92549, 93356, 93985, 93986, 95700, 95705, 95706, and 95707. Review completed 11/21/2019.
03/01/2019 R14

Corrected URL that was not connecting to the desired location.
03/01/2019 R13

03/01/2019: Clarification: The following CPT codes were inadvertently added to the 01/01/2019 revision history: 97151, 97152, 97153, 97154, 97155, 97156, 97157 and 97158. The coverage article and the CPT table did not include the listed codes which are not applicable or covered for this article.
01/01/2019 R12

01/01/2019 CPT/HCPCS annual update: Description changes: 74283, 77021, 93279, 93285, 93288, 93290, 93291, 93294, 93296, 93297, 93298, and 93299. Description corrections: 95017, 95018, 95076, 95079, 95907, 95908, 95909, 95910, 95911, 95912, 95913, and 95924. Deleted codes: 76001, 77058, 77059, 78270, 78271, 78272, and 92275. Added codes: 76391, 76978, 76979, 76981, 76982, 76983, 77046, 77047, 77048, 77049, 92273, 92274, 93264, 95836, 95976, 95977, 95983, 95984, 97151, 97152, 97153, 97154, 97155, 97156, 97157, 97158, 96112, 96113, 96121, 96310, 96131, 96132, 96133, 96136, 96137, 96138, 96139, and 96146. Annual review completed 11/30/2018. 
01/01/2018 R11

01/01/2018 - Corrected links that were incorrectly formatted and descriptions for codes 70110 and 78075 in Article Text section.
01/01/2018 R10


01/01/2018: CPT/HCPCS Annual update: Revised code descriptions 76000, 76881, 76882, 94621, 95930; Deleted codes 71010, 71015, 71020, 71021, 71022, 71023, 71030, 71034, 71035, 74000, 74010, 74020, 75658, 78190, 94620; and Added codes 71045, 71046, 71047, 71048, 74018, 74019, 74021, 94618. Reformatted CPT codes with long descriptions to short descriptions.  Annual review completed 12/01/2017. Grammatical corrections completed.
09/01/2017 R9

09/08/2017 - Updated URL link: https://www.nbrc.org/.  No change in coverage.
09/01/2017 R8

09/01/2017: Added CPT code 92540: Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with record, positional nystagmus test, minimum of 4 positions, with record, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tracking test, with recording. Physician Qualification: Neurologist or Otolaryngologist and Technician Qualification: Audiologist.
08/01/2017 R7

08/01/2017: CPT Code 74250 Technician Qualification: Removed Physician Only Service and added Certified Radiologic Technologist (ARRT:R.T.-R) and made grammatical corrections.
06/01/2017 R6 06/01/2017 Added CPT code 72159: Magnetic resonance angiography, spinal canal and contents with or without contrast material: Radiologist and Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR. Added CPT code 73225: Magnetic resonance angiography, upper extremity, with or without contrast material: Radiologist and Certified Radiologic Technologist (ARRT:R.T.-MR) or ARMRIT-RT-MR.
05/01/2017 R5 05/01/2017: CPT Code 75635 added Certified Radiologic Technologist (ARRT:R.T.-CT). Grammatical correction.
04/01/2017 R4 04/01/2017 Added additional Board Certification: National Center for Competency Testing for ECG Technician (NCET). Updated the technician requirements for codes 93000 & 93005 to include NCET-ECG Tech. Grammatical corrections.
02/16/2017 R3 01/01/2017- Annual Review completed 12/09/2016 and Code updates- Added 78350, 78351, 76706, 77065, 77066, 77067, 92242, 95076, 95079, 95905 and removed all deleted codes G0389, 71040, 71060, 75650, 75660, 75662, 75665, 75671, 75676, 75680, 75685, 75791, 75900, 77051, 77052, 77055-77057,78891, 92140, 93965, 95075, 95078 & description changes to codes 77002, 77003, 92235, 92240, 93312-93318, 93613, 93615, 93616, 93618, 93619, 93620, 93621, 93622, 93624, 93640-93642, 93644. Updated the physician and technician requirements for codes G0398-G0400 & 95782, 95783, 95800, 95801, 95805, 95806, 95807, 95808, 95810 & 95811 to reflect the information in our new Polysomnography and Other Sleep Studies LCD-effective 02/16/2016.
09/01/2016 R2 11/01/2016- Added Accreditation Commission for Health Care (ACHC) to the listing of allowable sleep center or laboratory facility accreditations that are listed under our physician requirements for sleep studies and Polysomnography testing section. Effective 09/01/2016.
04/01/2016 R1 06/01/2016- Updated the information under the Key for Abbreviations section: The physician (MD/DO) performing the service must meet the criteria in our Polysomnography and Other Sleep Studies LCD. Added additional board certifications AOBNP, AOBFP, AOBOO & updated the physician supervision requirements for codes G0398-G0400 & 95782, 95783, 95800, 95801, 95805, 95806, 95807, 95808, 95810 & 95811. Removed Board Certified (ABMS) by supervising physician requirement for CPT codes 78494 & 78496; typos corrected.
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Associated Documents

Medicare BPM Ch 15.50.2 SAD Determinations
Medicare BPM Ch 15.50.2
Related National Coverage Documents
NCDs
N/A
SAD Process URL 1
N/A
SAD Process URL 2
N/A
Statutory Requirements URLs
https://www.gpo.gov/fdsys/granule/CFR-2011-title42-vol2/CFR-2011-title42-vol2-sec410-32
Description: 42 CFR 410.32 - Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions.
https://www.gpo.gov/fdsys/pkg/CFR-2015-title42-vol2/pdf/CFR-2015-title42-vol2-sec410-33.pdf
Description: 42 CFR Ch. IV (10–1–15 Edition) § 410.33 Independent diagnostic testing facility
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Rules and Regulations URLs
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CMS Manual Explanations URLs
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c35.pdf
Description: Medicare Claims Processing Manual, Chapter 35- Independent Diagnostic Testing
https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R727OTN.pdf
Description: Mailing To All Individual Practitioners, Medical Groups and Clinics and Independent Diagnostic Testing Facilities (IDTF) Who Are Billing or Have Billed For Advanced Diagnostic Imaging Services.
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Other URLs
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Public Versions
Updated On Effective Dates Status
02/20/2026 02/26/2026 - N/A Currently in Effect You are here
01/08/2026 01/01/2026 - 02/25/2026 Superseded View
12/23/2025 01/01/2026 - N/A Superseded View
01/22/2025 01/01/2025 - 12/31/2025 Superseded View
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