Medicare NCCI Procedure to Procedure (PTP) Edits

National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits prevent inappropriate payment of services that should not be reported together. Each edit has a Column One and Column Two HCPCS/CPT code. If a provider reports the two codes of an edit pair for the same beneficiary on the same date of service, the Column One code is eligible for payment, but the Column Two code is denied unless a clinically appropriate NCCI PTP-associated modifier is also reported.

Quarterly Version Update Changes

CMS posts changes to each of its NCCI PTP published edit files on a quarterly basis. This includes additions, deletions, and modifier indicator quarterly changes to PTP column one/column two correct coding edits and the PTP mutually exclusive code edits for Practitioners and Hospital Outpatient PPS in the Outpatient Code Editor.

Related Downloads

2026 Quarter 1 Edit Files:

Hospital PTP Edits

Hospital PTP Edits v320r0 (475,004 Records) 0001A/0591T -- 24345/G0471 - Effective January 1, 2026; Posted Dec 1, 2025

Hospital PTP Edits v320r0 (475,125 Records) 24346/0213T -- 36563/G0471 - Effective January 1, 2026; Posted Dec 1, 2025

Hospital PTP Edits v320r0 (474,986 Records) 36565/0213T -- 61626/G0471 - Effective January 1, 2026; Posted Dec 1, 2025

Hospital PTP Edits v320r0 (433,720 Records) 61630/0213T -- U0003/U0004 - Effective January 1, 2026; Posted Dec 1, 2025

Practitioner PTP Edits

Practitioner PTP Edits v320r0 (675,063 Records) 0001A/0591T -- 25505/J2001 - Effective January 1, 2026; Posted Dec 1, 2025

Practitioner PTP Edits v320r0 (675,131 Records) 25515/01810 -- 37700/G0471 - Effective January 1, 2026; Posted Dec 1, 2025

Practitioner PTP Edits v320r0 (674,867 Records) 37718/0213T -- 62369/G0453 - Effective January 1, 2026; Posted Dec 1, 2025

Practitioner PTP Edits v320r0 (602,358 Records) 62370/0213T -- U0003/U0004 - Effective January 1, 2026; Posted Dec 1, 2025

2025 Quarter 4 Edit Files:

Hospital PTP Edits

Hospital PTP Edits v313r0 (475,179 Records) 0001A/0591T -- 24346/G0471 - Effective October 1, 2025; Posted Sep 1, 2025

Hospital PTP Edits v313r0 (474,897 Records) 24350/11012 -- 36563/G0471 - Effective October 1, 2025; Posted Sep 1, 2025

Hospital PTP Edits v313r0 (474,985 Records) 36565/0213T -- 61626/G0471 - Effective October 1, 2025; Posted Sep 1, 2025

Hospital PTP Edits v313r1 (433,720 Records) 61630/0213T -- U0003/U0004 - Effective October 1, 2025; Posted Oct 15, 2025

Practitioner PTP Edits

Practitioner PTP Edits v313r0 (675,009 Records) 0001A/0591T -- 25505/J2001 - Effective October 1, 2025; Posted Sep 1, 2025

Practitioner PTP Edits v313r0 (675,130 Records) 25525/01810 -- 37700/G0471 - Effective October 1, 2025; Posted Sep 1, 2025

Practitioner PTP Edits v313r0 (674,866 Records) 37718/0213T -- 62369/G0453 - Effective October 1, 2025; Posted Sep 1, 2025

Practitioner PTP Edits v313r1 (602,358 Records) 62370/0213T-- U0003/U0004 - Effective October 1, 2025; Posted Oct 15, 2025