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 3 Edit Files:

Hospital PTP Edits

Hospital PTP Edits v322r0 (475,091 Records) 0001A/0591T -- 24150/G0471 - Effective July 1, 2026; Posted June 1, 2026

Hospital PTP Edits v322r0 (475,181 Records) 24151/10060 -- 36482/G0471 - Effective July 1, 2026; Posted June 1, 2026

Hospital PTP Edits v322r0 (474,870 Records) 36483/0213T -- 61590/G0471 - Effective July 1, 2026; Posted June 1, 2026

Hospital PTP Edits v322r0 (439,587 Records) 61591/0213T -- U0003/U0004 - Effective July 1, 2026; Posted June 1, 2026

Practitioner PTP Edits

Practitioner PTP Edits v322r0 (675,037 Records) 0001A/0591T -- 25441/G0471 - Effective July 1, 2026; Posted June 1, 2026

Practitioner PTP Edits v322r0 (675,235 Records) 25442/01810 -- 37252/99452 - Effective July 1, 2026; Posted June 1, 2026

Practitioner PTP Edits v322r0 (674,890 Records) 37253/0213T -- 62322/J2001 - Effective July 1, 2026; Posted June 1, 2026

Practitioner PTP Edits v322r0 (608,227 Records) 62323/0178T-- U0003/U0004 - Effective July 1, 2026; Posted June 1, 2026

2026 Quarter 2 Edit Files:

Hospital PTP Edits

Hospital PTP Edits v321r0 (475,011 Records) 0001A/0591T -- 24220/G0471 - Effective April 1, 2026; Posted March 2, 2026

Hospital PTP Edits v321r0 (475,169 Records) 24300/0213T -- 35513/G0505 - Effective April 1, 2026; Posted March 2, 2026

Hospital PTP Edits v321r0 (475,020 Records) 36514/0213T -- 61601/G0471 - Effective April 1, 2026; Posted March 2, 2026

Hospital PTP Edits v321r0 (437,350 Records) 61605/0213T -- U0003/U0004 - Effective April 1, 2026; Posted March 2, 2026

Practitioner PTP Edits

Practitioner PTP Edits v321r0 (675,270 Records) 0001A/0591T -- 25447/G0471 - Effective April 1, 2026; Posted March 2, 2026

Practitioner PTP Edits v321r0 (674,903 Records) 25448/01810 -- 37606/G0471 - Effective April 1, 2026; Posted March 2, 2026

Practitioner PTP Edits v321r0 (674,869 Records) 37607/0213T -- 62328/G0471 - Effective April 1, 2026; Posted March 2, 2026

Practitioner PTP Edits v321r0 (606,146 Records) 62329/00635-- U0003/U0004 - Effective April 1, 2026; Posted March 2, 2026