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FINAL 2013 Compared to FINAL 2014 Rates Medicare Hospital Outpatient Prospective Payment System HOPPS (APC) Nuclear Medicine Procedures, , and Drugs Click here for Link to References: CMS Website HOPPS CY 2014 Final Rule (Fed. Reg. Version add B)

Updated November 27, 2013 Indicator Service Status Not paid under OPPS. Paid by fiscal intermediaries/MACs under a fee Services furnished to a hospital outpatient that are paid under a fee schedule or schedule or payment system other than OPPS. Services are subject to payment system other than OPPS, for example: deductible or coinsurance unless indicated otherwise. ● Ambulance Services ● Separately Payable Clinical Diagnostic Laboratory Services Not subject to deductible or coinsurance. A ● Non-Implantable Prosthetic and Orthotic Devices ● EPO for ESRD Patients ● Physical, Occupational, and Speech Therapy ● Diagnostic Mammography ● Screening Mammography Not subject to deductible or coinsurance. Items, Codes, and Services: ● That are not covered by any Medicare outpatient benefit based on statutory exclusion ● That are not covered by any Medicare outpatient benefit for reasons other than Not paid by Medicare when submitted on outpatient claims (any E statutory exclusion outpatient bill type). ● That are not recognized by Medicare for outpatient claims but for which an alternate code for the same item or service may be available. ● For which separate payment is not provided on outpatient claims G Pass-Through Drug/ Biologicals Paid under OPPS; separate APC payment. NonPass-Through Drugs and nonimplantable Biologicals, including Therapeutic K Paid under OPPS; separate APC payment. Radiopharmaceuticals Paid under OPPS; payment is packaged into payment for other N Items and Services packaged into APC rate services. Therefore, there is no separate APC payment. Paid under OPPS; Addendum B displays APC assignments when services are separately payable. (1) Packaged APC payment if billed on the same date of service as a Q1 STVX-Packaged Codes (e.g 38792 separately payable is only item on claim for SDOS) HCPCS code assigned status indicator “S,” “T,”“V,” or "X." (2) In other circumstances, payment is made through a separate APC payment. T Significant Procedure, Multiple Procedure Reduction Applies Paid under OPPS; separate APC payment. X Ancillary Services Paid under OPPS; separate APC payment.

FINAL FINAL RULE CPT/ 2013-F 2014-F 2013-F 2014-F RULE CY % Trade CY 2014 2013 Payment Payment HCPCS APC APC SI SI Change Description Name Rate Rate

38792 Injection procedure; for identification of sentinel node 0392 0392 Q1 Q1 $196.59 $257.43 30.9%

Intraoperative identification (eg, mapping) of sentinel lymph node(s) includes injection of non-radioactive dye, when performed (List separately in addition to code for primary procedure) 38900 (For injection of radioactive tracer for identification of sentinel node, use N/A N N N/A N/A N/A 38792) (Use in conjunction with 19302,19307,38500,38510, 38520,38525,38530,38542,38740,38745)

Injection procedure (eg, contrast media) for evaluation of previously placed Packaged Packaged 49427 peritoneal-venous shunt (For radiological supervision and interpretation, N N into APC into APC rate see 75809, 78291) rate Insertion of non-indwelling bladder catheter (eg, straight catheterization for 51701 0340 0420 X X $49.64 $98.25 97.9% residual urine) 51702 Insertion of temporary indwelling bladder catheter; simple (eg, Foley) 0340 0420 X X $49.64 $98.25 97.9% Insertion of temporary indwelling bladder catheter; complicated (eg, altered 51703 0126 0164 T T $81.99 $211.10 157.5% anatomy, fractured catheter/balloon)

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FINAL FINAL RULE CPT/ 2013-F 2014-F 2013-F 2014-F RULE CY % Trade CY 2014 2013 Payment Payment HCPCS APC APC SI SI Change Description Name Rate Rate 3D rendering with interpretation and reporting of computed of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality; not requiring image postprocessing on an independent workstation (Use 76376 in conjunction with codes(s) for base imaging Packaged Packaged 76376 procedure(s)) N/A N N into APC into APC rate (Do not report 76376 in conjunction with 70496, 70498, 70544-70549, rate 71275, 71555, 72159, 72191, 72198, 73206, 73225, 73706, 73725, 74175, 74185, 75557-75564, 75635, 76377, 78000-78999, 0066T, 0067T, 0144T- 0151T, 0159T) 3D rendering with interpretation and reporting of computed of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality; requiring image postprocessing on an independent workstation Packaged (Use 76377 in conjunction with codes(s) for base imaging procedure(s)) Packaged 76377 N/A N N into APC (Do not report 76377 in conjunction with 70496, 70498, 70544-70549, into APC rate rate 71275, 71555, 72159, 72191, 72198, 73206, 73225, 73706, 73725, 74175, 74185, 75557-75564, 75635, 76376, 78000-78999, 0066T, 0067T, 0144T- 0151T, 0159T)

77370 Special medical radiation physics consultation 0304 0304 X X $109.73 $114.65 4.5%

NUCLEAR MEDICINE Modified in 2013 INTRODUCTORY SECTION - The services listed do not include the or drug. To separately report supply of diagnostic and therapeutic radiopharmaceutiacls nd drugs, use the appropriate supply code(s), in addition to the procedure code.

Thyroid uptake, single or multiple quantitative measurement(s) (including 78012 0389 0389 S S $114.03 $140.39 23.1% stimulation, suppression, or discharge, when performed) 78013 Thyroid imaging (including vascular flow, when performed) 0390 0390 S S $150.04 $183.40 22.2% Thyroid imaging (including vascular flow, when performed); with single or 78014 multiple uptake(s) quantitative measurement(s) (including stimulation, 0391 0391 S S $232.94 $286.94 23.2% suppression, or discharge, when performed) Thyroid carcinoma metastases imaging; limited are (eg, neck and chest 78015 0406 0406 S S $300.09 $382.77 27.6% only) Thyroid carcinoma metastases imaging; with additional studies (eg, urinary 78016 0406 0406 S S $300.09 $382.77 27.6% recovery) 78018 Thyroid carcinoma metastases imaging; whole body 0406 0406 S S $300.09 $382.77 27.6% Packaged Thyroid carcinoma metastases uptake (Use in conjunction with code 78018 Packaged 78020 + N/A N N into APC only) into APC rate rate 78070 Parathyroid planar imaging (including subtraction, when performed) 0391 0391 S S $232.94 $286.94 23.2%

Parathyroid planar imaging (including subtraction, when performed); with 78071 0317 0317 X X $322.04 $738.69 129.4% tomographic (SPECT) Parathyroid planar imaging (including subtraction, when performed); with 78072 tomographic (SPECT), and concurrently acquired computed 0317 0317 X X $322.04 $738.69 129.4% tomography (CT) for anatomical localization 78075 Adrenal imaging, cortex and/or medulla 0408 0408 S S $955.60 $1,157.42 21.1% 78099 Unlisted endocrine procedure, diagnostic nuclear medicine 0390 0390 S S $150.04 $183.40 22.2% 78102 Bone marrow imaging; limited area 0400 0400 S S $279.95 $346.34 23.7% 78103 Bone marrow imaging; multiple areas 0400 0400 S S $279.95 $346.34 23.7% 78104 Bone marrow imaging; whole body 0400 0400 S S $279.95 $346.34 23.7% Plasma volume, radiopharmaceutical volume-dilution technique (separate 78110 0393 0393 S S $435.79 $565.95 29.9% procedure); single sampling Plasma volume, radiopharmaceutical volume-dilution technique (separate 78111 0393 0393 S S $435.79 $565.95 29.9% procedure); multiple sampling

78120 Red cell volume determination (separate procedure); single sampling 0393 0393 S S $435.79 $565.95 29.9%

78121 Red cell volume determination (separate procedure); multiple sampling 0393 0393 S S $435.79 $565.95 29.9% Whole blood volume determination, including separate measurement of 78122 plasma volume and red cell volume (radiopharmaceutical volume-dilution 0393 0393 S S $435.79 $565.95 29.9% technique) 78130 Red cell survival study; 0393 0393 S S $435.79 $565.95 29.9% Red cell survival study; differential organ/tissue kinetics (eg, splenic and/or 78135 0393 0393 S S $435.79 $565.95 29.9% hepatic sequestration) Labeled red cell sequestration, differential organ/tissue, (eg, splenic and/or 78140 0393 0393 S S $435.79 $565.95 29.9% hepatic) Spleen imaging only, with or without vascular flow (If combined with 78185 0400 0400 S S $279.95 $346.34 23.7% study, use procedures 78215 and 78216) Kinetics, study of platelet survival, with or without differential organ/tissue 78190 0392 0392 S S $196.59 $257.43 30.9% localization 78191 Platelet survival study 0392 0392 S S $196.59 $257.43 30.9%

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FINAL FINAL RULE CPT/ 2013-F 2014-F 2013-F 2014-F RULE CY % Trade CY 2014 2013 Payment Payment HCPCS APC APC SI SI Change Description Name Rate Rate Lymphatics and lymph nodes imaging (For sentinel node identification 78195 0400 0400 S S $279.95 $346.34 23.7% without imaging, use 38792) Unlisted hematopoietic, Reticuloendothelial and lymphatic procedure, 78199 0400 0400 S S $279.95 $346.34 23.7% diagnostic nuclear medicine 78201 Liver imaging; static only 0394 0394 S S $314.39 $372.57 18.5% 78202 Liver imaging; with vascular flow 0394 0394 S S $314.39 $372.57 18.5% 78205 Liver imaging (SPECT); 0394 0394 S S $314.39 $372.57 18.5% 78206 Liver image (SPECT); with vascular flow 0394 0394 S S $314.39 $372.57 18.5% 78215 Liver and spleen imaging; static only 0394 0394 S S $314.39 $372.57 18.5% 78216 Liver and spleen imaging; with vascular flow 0394 0394 S S $314.39 $372.57 18.5% 78226 Hepatobiliary system imaging, including gallbladder when present 0394 0394 S S $314.39 $372.57 18.5% Hepatobiliary system imaging, including gallbladder when present; with 78227 pharmacologic intervention, including quantitative measurement(s) when 0394 0394 S S $314.39 $372.57 18.5% performed 78230 Salivary gland imaging; 0395 0395 S S $256.76 $323.78 26.1% 78231 Salivary gland imaging; with serial images 0395 0395 S S $256.76 $323.78 26.1% 78232 Salivary gland function study 0395 0395 S S $256.76 $323.78 26.1% 78258 Esophageal motility 0395 0395 S S $256.76 $323.78 26.1% 78261 Gastric mucosa imaging 0395 0395 S S $256.76 $323.78 26.1% 78262 Gastroesophageal reflux study 0395 0395 S S $256.76 $323.78 26.1% 78264 Gastric emptying study 0395 0395 S S $256.76 $323.78 26.1% 78267 Urea breath test, C-14 (isotopic); acquisition for analysis A A 78268 Urea breath test, C-14 (isotopic); analysis A A 78270 Vit B-12 absorption study (eg, Schilling test); without intrinsic factor 0392 0392 S S $196.59 $257.43 30.9%

78271 Vit B-12 absorption study (eg, Schilling test); with intrinsic factor 0392 0392 S S $196.59 $257.43 30.9%

78272 Vit B-12 absorption study combined, with and without intrinsic factor 0392 0392 S S $196.59 $257.43 30.9% 78278 Acute gastrointestinal blood loss imaging 0395 0395 S S $256.76 $323.78 26.1% 78282 Gastrointestinal protein loss 0395 0395 S S $256.76 $323.78 26.1% Intestine imaging (eg, ectopic gastric mucosa, Meckel’s localization, 78290 0395 0395 S S $256.76 $323.78 26.1% volvulus) 78291 Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) 0395 0395 S S $256.76 $323.78 26.1%

78299 Unlisted gastrointestinal procedure, diagnostic nuclear medicine 0395 0395 S S $256.76 $323.78 26.1% 78300 Bone and/or joint imaging; limited area 0396 0396 S S $261.68 $323.94 23.8% 78305 Bone and/or joint imaging; multiple areas 0396 0396 S S $261.68 $323.94 23.8% 78306 Bone and/or joint imaging; whole body 0396 0396 S S $261.68 $323.94 23.8% 78315 Bone and/or joint imaging; 3 three phase study 0396 0396 S S $261.68 $323.94 23.8% 78320 Bone and/or joint imaging; tomographic (SPECT) 0396 0396 S S $261.68 $323.94 23.8% Bone density (bone mineral content) study , 1 or more sites; single photon 78350 N/A E E N/A N/A N/A absorptiometry Bone density (bone mineral content) study , 1 or more sites; dual photon 78351 N/A E E N/A N/A N/A absorptiometry one or more sites 78399 Unlisted musculoskeletal procedure, diagnostic nuclear medicine 0396 0396 S S $261.68 $323.94 23.8% Determination of central c-v hemodynamics (non-imagine) (eg, ejection 78414 fraction with probe technique) with or without pharmacologic intervention or 0398 0398 S S $308.99 $383.10 24.0% exercise, single or multiple determinations 78428 Cardiac shunt detection 0398 0398 S S $308.99 $383.10 24.0% 78445 Non-cardiac vascular flow imaging (ie, angiography, venography) 0397 0263 S X $330.97 $317.91 -3.9% Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first 78451 0377 0377 S S $679.68 $1,153.62 69.7% pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic) Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first 78452 pass or gated technique, additional quantification, when performed); 0377 0377 S S $679.68 $1,153.62 69.7% multiple studies, at rest and/or stress (exercise or pharmacologic) and/or redistribution and/or rest reinjection Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional 78453 0377 0377 S S $679.68 $1,153.62 69.7% quantification, when performed); single study, at rest or stress (exercise or pharmacologic)

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FINAL FINAL RULE CPT/ 2013-F 2014-F 2013-F 2014-F RULE CY % Trade CY 2014 2013 Payment Payment HCPCS APC APC SI SI Change Description Name Rate Rate Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional 78454 0377 0377 S S $679.68 $1,153.62 69.7% quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or redistribution and/or rest reinjection 78456 Acute venous thrombus imaging, peptide 0397 0317 S X $330.97 $738.69 123.2% 78457 Venous thrombosis imaging, venogram; unilateral 0397 0263 S X $330.97 $317.91 -3.9% 78458 Venous thrombosis imaging, venogram; bilateral 0397 0263 S X $330.97 $317.91 -3.9% Myocardial imaging, positron emission tomography (PET), metabolic 78459 0308 0308 S S $1,056.12 $1,310.60 24.1% evaluation 78466 Myocardial imaging, infarct avid, planar; qualitative or quantitative 0398 0398 S S $308.99 $383.10 24.0% Myocardial imaging, infarct avid, planar; with ejection fraction by first pass 78468 0398 0398 S S $308.99 $383.10 24.0% technique Myocardial imaging, infarct avid, planar; tomographic SPECT with or without 78469 0398 0398 S S $308.99 $383.10 24.0% quantification Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection 78472 0398 0398 S S $308.99 $383.10 24.0% fraction, with or without additional quantitative processing (or assessment of cardiac function by first pass technique, use 78496) Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion 78473 study plus ejection fraction, at rest and stress (exercise and/or 0398 0398 S S $308.99 $383.10 24.0% pharmacologic), with or without additional quantification

Cardiac blood pool imaging (planar), first pass technique; single study, at 78481 rest or with stress (exercise and/or pharmacologic), wall motion study plus 0398 0398 S S $308.99 $383.10 24.0% ejection fraction, with or without quantification

Cardiac blood pool imaging (planar), first pass technique; multiple studies, 78483 at rest and with stress (exercise and/or pharmacologic), wall motion study 0398 0377 S S $308.99 $1,153.62 273.4% plus ejection fraction, with or without quantification Myocardial imaging, positron emission tomography (PET), perfusion; single 78491 0308 0308 S S $1,056.12 $1,310.60 24.1% study at rest or stress Myocardial imaging, positron emission tomography (PET), perfusion; 78492 0308 0308 S S $1,056.12 $1,310.60 24.1% multiple studies at rest and/or stress Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion 78494 0398 0398 S S $308.99 $383.10 24.0% study plus ejection fraction, with or without quantitative processing Cardiac blood pool imaging, gated equilibrium, single study, at rest, with Packaged Packaged 78496 + right ventricular ejection fraction by first pass technique (Use 78496 in N/A N N into APC into APC rate conjunction with 78472) rate 78499 Unlisted cardiovascular procedure, diagnostic nuclear medicine 0398 0398 S S $308.99 $383.10 24.0%

Myocardial sympathetic innervation, imaging, planar qualitative 0331T 0398 0377 S S $308.99 $1,153.62 N/A assessment Myocardial sympathetic innervation, imaging, planar qualitative and 0332T 0398 0377 S S $308.99 $1,153.62 N/A quantitative assessment; with tomographic SPECT 78579 Pulmonary ventilation imaging (eg, aerosol or gas) 0401 0401 S S $220.96 $306.01 38.5% 78580 Pulmonary perfusion imaging (eg, particulate) 0401 0401 S S $220.96 $306.01 38.5%

78582 Pulmonary ventilation imaging (eg, aerosol or gas) and perfusion imaging 0378 0378 S S $336.40 $430.87 28.1% Quantitative differential pulmonary perfusion, including imaging when 78597 0401 0401 S S $220.96 $306.01 38.5% performed Quantitative differential pulmonary perfusion and ventilation (eg aerosol or 78598 0378 0378 S S $336.40 $430.87 28.1% gas), including imaging when performed 78599 Unlisted respiratory procedure, diagnostic nuclear medicine 0401 0401 S S $220.96 $306.01 38.5% 78600 Brain imaging, less than 4 static views; 0403 0403 S S $264.09 $162.68 -38.4% 78601 Brain imaging, less than 4 static views; with vascular flow 0402 0402 S S $458.34 $533.18 16.3% 78605 Brain imaging, minimum 4 static views; 0403 0402 S S $264.09 $533.18 101.9% 78606 Brain imaging, minimum 4 static views; with vascular flow 0402 0402 S S $458.34 $533.18 16.3% 78607 Brain imaging, tomographic (SPECT) 0402 0408 S S $458.34 $1,157.42 152.5%

78608 Brain imaging, positron emission tomography (PET); metabolic evaluation 0308 0308 S S $1,056.12 $1,310.60 24.1%

78609 Brain imaging, positron emission tomography (PET); perfusion evaluation E E 78610 Brain imaging, vascular flow only 0403 0402 S S $264.09 $533.18 101.9% Cerebrospinal fluid flow, imaging (not including introduction of material); 78630 0402 0402 S S $458.34 $533.18 16.3% cisternography (For injection procedure, see 61000-61070, 62270-62319)

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FINAL FINAL RULE CPT/ 2013-F 2014-F 2013-F 2014-F RULE CY % Trade CY 2014 2013 Payment Payment HCPCS APC APC SI SI Change Description Name Rate Rate Cerebrospinal fluid flow, imaging (not including introduction of material); 78635 0402 0402 S S $458.34 $533.18 16.3% ventriculography (For injection procedure, see 61000-61070, 62270-62294)

Cerebrospinal fluid flow, imaging (not including introduction of material); 78645 0403 0402 S S $264.09 $533.18 101.9% shunt evaluation (For injection procedure, see 61000-61070, 62270-62294)

Cerebrospinal fluid flow, imaging (not including introduction of material); 78647 0402 0402 S S $458.34 $533.18 16.3% tomographic (SPECT)

78650 Cerebrospinal fluid leakage detection and localization 0402 0402 S S $458.34 $533.18 16.3% 78660 Radiopharmaceutical dacryocystography 0403 0403 S S $264.09 $162.68 -38.4% 78699 Unlisted nervous system procedure, diagnostic nuclear medicine 0403 0403 S S $264.09 $162.68 -38.4% 78700 imaging morphology 0404 0404 S S $332.91 $417.02 25.3% 78701 Kidney imaging morphology with vascular flow 0404 0404 S S $332.91 $417.02 25.3% Kidney imaging morphology with vascular flow and function, single study 78707 0404 0404 S S $332.91 $417.02 25.3% without pharmacological intervention Kidney imaging morphology with vascular flow and function, single study, 78708 with pharmacological intervention (eg, angiotensin converting enzyme 0404 0404 S S $332.91 $417.02 25.3% inhibitor and/or diuretic) Kidney imaging morphology with vascular flow and function, multiple 78709 studies, with and without pharmacological intervention (eg, angiotensin 0404 0404 S S $332.91 $417.02 25.3% converting enzyme inhibitor and/or diuretic) 78710 Kidney imaging morphology tomographic (SPECT) 0404 0404 S S $332.91 $417.02 25.3% 78725 Kidney function study, non-imaging radioisotopic study 0392 0392 S S $196.59 $257.43 30.9% Urinary bladder residual study (List separately in addition to code for primary procedure) (Use 78730 in conjunction with 78740) (For measurement of postvoid residual urine and/or bladder capacity by Packaged 78730 + 0389 S N $114.03 ultrasound, nonimaging, use 51798) (For ultrasound imaging of the bladder into APC rate only, with measurement of postvoid residual urine when performed, use 76857) Ureteral reflux study (radiopharmaceutical voiding cystogram) For 78740 0404 0404 S S $332.91 $417.02 25.3% catheterization see 51701, 51702, 51703 78761 Testicular imaging with vascular flow 0404 0404 S S $332.91 $417.02 25.3% 78799 Unlisted genitourinary procedure; diagnostic nuclear medicine 0404 0404 S S $332.91 $417.02 25.3% Radiopharmaceutical localization of tumor or distribution of 78800 0406 0406 S S $300.09 $382.77 27.6% radiopharmaceutical agent(s); limited area Radiopharmaceutical localization of tumor or distribution of 78801 0414 0406 S S $502.54 $382.77 -23.8% radiopharmaceutical agent(s); multiple areas Radiopharmaceutical localization of tumor or distribution of 78802 0414 0414 S S $502.54 $656.97 30.7% radiopharmaceutical agent(s); whole body, single day imaging Radiopharmaceutical localization of tumor or distribution of 78803 0414 0414 S S $502.54 $656.97 30.7% radiopharmaceutical agent(s); tomographic (SPECT) Radiopharmaceutical localization of tumor or distribution of 78804 radiopharmaceutical agent(s); whole body, requiring 2 or more days 0408 0408 S S $955.60 $1,157.42 21.1% imaging 78805 Radiopharmaceutical localization of inflammatory process; limited area 0414 0414 S S $502.54 $656.97 30.7%

78806 Radiopharmaceutical localization of inflammatory process; whole body 0414 0414 S S $502.54 $656.97 30.7%

Radiopharmaceutical localization of inflammatory process; tomographic 78807 (SPECT) (For imaging bone infectious or inflammatory disease with a bone 0414 0414 S S $502.54 $656.97 30.7% imaging radiopharmaceutical, see 78300, 78305, 78306) Injection procedure for radiopharmaceutical localization by non-imaging 78808 probe study, intravenous (eg, parathyroid adenoma) 0392 0392 Q1 Q1 $196.59 $257.43 30.9% (For sentinel lymph node identification, use 38792) Positron emission tomography (PET) imaging; limited area (eg. chest, 78811 0308 0308 S S $1,056.12 $1,310.60 24.1% head/neck) 78812 Positron emission tomography (PET) imaging; skull base to mid-thigh 0308 0308 S S $1,056.12 $1,310.60 24.1%

78813 Positron emission tomography (PET) imaging; whole body 0308 0308 S S $1,056.12 $1,310.60 24.1% Positron emission tomography (PET) with concurrently acquired computed 78814 tomography (CT) for attenuation correction and anatomical localization 0308 0308 S S $1,056.12 $1,310.60 24.1% imaging; limited area (eg, chest, head/neck) Positron emission tomography (PET) with concurrently acquired computed 78815 tomography (CT) for attenuation correction and anatomical localization 0308 0308 S S $1,056.12 $1,310.60 24.1% imaging; skull base to mid-thigh Positron emission tomography (PET) with concurrently acquired computed 78816 tomography (CT) for attenuation correction and anatomical localization 0308 0308 S S $1,056.12 $1,310.60 24.1% imaging; whole body

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FINAL FINAL RULE CPT/ 2013-F 2014-F 2013-F 2014-F RULE CY % Trade CY 2014 2013 Payment Payment HCPCS APC APC SI SI Change Description Name Rate Rate (Report 78811-78816 only once per imaging session) (Computed tomography (CT) performed for other than attenuation correction and anatomical localization is reported using the appropriate site specific CT code with modifier 59) 78999 Unlisted miscellaneous procedure, diagnostic nuclear medicine 0389 0389 S S $114.03 $140.39 23.1%

C9898 Radiolabeled product provided during a hospital inpatient stay N N Radiopharmaceutical therapy, by oral administration (For monoclonal 79005 0407 0407 S S $236.71 $255.81 8.1% antibody by intravenous infusion, use 79403) Radiopharmaceutical therapy, by intravenous administration (Do not report 79101 in conjunction with 36400, 35410, 79403, 90780, 96408) (For 79101 monoclonal antibody by intravenous infusion, use 79403) (For infusion or 0407 0407 S S $236.71 $255.81 8.1% instillation of non-antibody radioelement solution that includes three months follow-up care, use 77750) 79200 Radiopharmaceutical therapy, by intracavitary administration 0413 0413 S S $301.01 $356.68 18.5% Radiopharmaceutical therapy, by interstitial radioactive colloid 79300 0407 0407 S S $236.71 $255.81 8.1% administration Radiopharmaceutical therapy, radiolabeled monoclonal antibody by 79403 intravenous infusion (For pre-treatment imaging, see 78802, 78804) (Do not 0413 0413 S S $301.01 $356.68 18.5% use in conjunction with 79101) 79440 Radiopharmaceutical therapy, by intra-articular administration 0413 0413 S S $301.01 $356.68 18.5% Radiopharmaceutical therapy, by intra-arterial particulate administration (Do not report 79445 in conjunction with 90783, 96420) (Use appropriate 79445 procedural and radiological supervision and interpretation codes for the 0407 0407 S S $236.71 $255.81 8.1% angiographic and interventional procedures provided pre-requisite to intra- arterial radiopharmaceutical therapy) 79999 Radiopharmaceutical therapy, unlisted procedure 0407 0407 S S $236.71 $255.81 8.1% Cardiovascular stress test using maximal or submaximal treadmill or bicycle 93017 exercise, continuous electrocardiographic monitoring, and/or 0100 0100 X Q1 $176.82 $244.21 38.1% pharmacological stress; tracing only, without interpretation and report Chemotherapy administration, intravenous infusion technique; up to one 96413 0440 0440 S S $230.50 $299.53 29.9% hour, single or initial substance/drug G0219 PET imaging whole body; melanoma for non-covered indications E E G0235 PET IMAGING, ANY SITE, NOT OTHERWISE SPECIFIED E E PET imaging, full & partial-ring PET scanner only, for initial diagnosis of G0252 breast cancer and/or surgical planning for breast cancer (eg, initial staging E E of axillary lymph nodes) CY 2013 CY 2014 % RADIOPHARMACEUTICALS & NUCLEAR MEDICINE RELATED DRUGS SI FINAL FINAL Change Non-HEU TC-99M Add-On/Dose 95 percent NON- $2.00 Co- Q9969 Tc-99m from non-highly enriched uranium source, full cost 1442 1442 K K $10.00 $10.00 HEU Product Insurance recovery add-on, per study dose Radiopharm dx agent noc Packaged Packaged A4641 RADIOPHARMACEUTICAL, DIAGNOSTIC, NOT N N into APC into APC rate OTHERWISE CLASSIFIED rate In111 satumomab Packaged INDIUM IN-111 SATUMOMAB PENDETIDE, ONCOSCINT Packaged A4642 N N into APC DIAGNOSTIC, PER STUDY DOSE, UP TO 6 ® into APC rate rate MILLICURIES Tc99m sestamibi CARDIOLITE Packaged Packaged A9500 TECHNETIUM TC-99M SESTAMIBI, DIAGNOSTIC, PER ® / N N into APC into APC rate STUDY DOSE, UP TO 40 MILLICURIES MIRALUMA® rate Technetium TC-99m teboroxime Packaged TECHNETIUM TC-99M TEBOROXIME, DIAGNOSTIC, CardioTec® Packaged A9501 N N into APC PER STUDY DOSE TEBO into APC rate rate Tc99m tetrofosmin Packaged Packaged A9502 TECHNETIUM TC-99M TETROFOSMIN, DIAGNOSTIC, MYOVIEW® N N into APC into APC rate PER STUDY DOSE rate Tc99m medronate Packaged Packaged A9503 MDP N N into APC TECHNETIUM TC-99M MEDRONATE, DIAGNOSTIC, PER into APC rate rate STUDY DOSE, UP TO 30 MILLICURIES Tc99m apcitide Packaged TECHNETIUM TC-99M APCITIDE, DIAGNOSTIC, PER Packaged A9504 ACUTECT® N N into APC STUDY DOSE, UP TO 20 MILLICURIES into APC rate rate

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FINAL FINAL RULE CPT/ 2013-F 2014-F 2013-F 2014-F RULE CY % Trade CY 2014 2013 Payment Payment HCPCS APC APC SI SI Change Description Name Rate Rate TL201 thallium Packaged THALLIUM Packaged A9505 N N into APC THALLIUM TL-201 THALLOUS CHLORIDE, DIAGNOSTIC, 201 into APC rate rate PER MILLICURIE In111 capromab Packaged Packaged A9507 PROSTASCINT® N N into APC INDIUM IN-111 CAPROMAB PENDETIDE, DIAGNOSTIC, into APC rate rate PER STUDY DOSE, UP TO 10 MILLICURIES I131 iodobenguate, dx Packaged Packaged A9508 I-131 MIBG N N into APC IODINE I-131 SULFATE, DIAGNOSTIC, into APC rate rate PER 0.5 MILLICURIE

Use for 1-4 mCi doses of I- 123 for whole Iodine I-123 sod iodide mil body imaging Packaged Packaged A9509 for less than 1 N N into APC IODINE I-123 SODIUM IODIDE, DIAGNOSTIC, PER into APC rate mCi and rate MILLICURIE thyroid imaging see A9516 Tc99m disofenin Packaged Packaged A9510 TECHNETIUM TC-99M DISOFENIN, DIAGNOSTIC, PER DISIDA N N into APC into APC rate STUDY DOSE, UP TO 15 MILLICURIES rate

Straight Tech Packaged Tc99m pertechnetate TECHNETIUM TC- Packaged A9512 Technescan N N into APC 99M PERTECHNETATE, DIAGNOSTIC, PER MILLICURIE into APC rate Technelite rate Dx I-123 Capsules. Use for A9516 for Thyroid Iodine I-123 sod iodide mCi uptakes and Packaged IODINE I-123 SODIUM IODIDE, DIAGNOSTIC, PER 100 Packaged A9516 scans, for 1 N N into APC MICROCURIES, UP TO 999 MICROCURIES into APC rate mCi and rate greater and whole body imaging see A9509 I131 iodide cap, rx Rx I-131 A9517 IODINE I-131 SODIUM IODIDE CAPSULE(S), 1064 1064 K K $40.70 $18.52 -54.5% Capsules THERAPEUTIC, PER MILLICURIE LymphoSeek ™ Replaces ● A9520 Tc99 Tilmanocept Diag 0.5MCI Deleted See See NEW TECHNETIUM TC-99M TILMANOCEPT, DIAGNOSTIC, 1463 G See C1204 $223.15 C1204 NDC # C1204 C1204 2014 UP TO 0.5 MILLICURIES 52579-1600- 05 Tc99m exametazime Packaged CERETEC® Packaged A9521 N N into APC TECHNETIUM TC-99M EXAMETAZIME, DIAGNOSTIC, HMPAO into APC rate rate PER STUDY DOSE, UP TO 25 MILLICURIES I131 serum albumin, dx Packaged Packaged A9524 IODINE I-131 IODINATED SERUM ALBUMIN, I-131 Albumin N N into APC into APC rate DIAGNOSTIC, PER 5 MICROCURIES rate Nitrogen N-13 ammonia Packaged Packaged A9526 NITROGEN N-13 AMMONIA, DIAGNOSTIC, PER STUDY N-13 N N into APC into APC rate DOSE, UP TO 40 MILLICURIES rate Iodine I-125 sodium iodide A9527 IODINE I-125, SODIUM IODIDE SOLUTION, 2632 2632 U U $21.03 $18.97 -9.8% THERAPEUTIC, PER MILLICURIE Iodine I-131 iodide cap, dx Packaged I-131 Dx caps Packaged A9528 IODINE I-131 SODIUM IODIDE CAPSULE(S), N N into APC per mCi into APC rate DIAGNOSTIC, PER MILLICURIE rate I131 iodide sol, dx Packaged Dx I-131 sol Packaged A9529 IODINE I-131 SODIUM IODIDE SOLUTION, DIAGNOSTIC, N N into APC per mCi into APC rate PER MILLICURIE rate I131 iodide sol, rx Rx I-131 sol A9530 IODINE I-131 SODIUM IODIDE SOLUTION, 1150 1150 K K $11.23 $10.80 -3.8% per mCi THERAPEUTIC, PER MILLICURIE

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FINAL FINAL RULE CPT/ 2013-F 2014-F 2013-F 2014-F RULE CY % Trade CY 2014 2013 Payment Payment HCPCS APC APC SI SI Change Description Name Rate Rate I131 max 100uCi Packaged Dx I-131 up to Packaged A9531 IODINE I-131 SODIUM IODIDE, DIAGNOSTIC, PER N N into APC 100 uCi into APC rate MICROCURIE (UP TO 100 MICROCURIES) rate I125 serum albumin, dx Packaged Packaged A9532 IODINE I-125 SERUM ALBUMIN, DIAGNOSTIC, PER 5 N N into APC into APC rate MICROCURIES rate Tc99m depreotide Packaged TECHNETIUM TC-99M DEPREOTIDE, DIAGNOSTIC, Packaged A9536 NEOTEC® N N into APC PER STUDY DOSE, UP TO 35 MILLICURIES into APC rate rate Tc99m mebrofenin Packaged TECHNETIUM TC-99M MEBROFENIN, DIAGNOSTIC, Packaged A9537 CHOLETEC® N N into APC PER STUDY DOSE, UP TO 15 MILLICURIES into APC rate rate

PYROLITE® *Use this code for myocardial Tc99m pyrophosphate infarct TECHNETIUM TC-99M PYROPHOSPHATE, Packaged imaging. Do Packaged A9538 DIAGNOSTIC, PER STUDY DOSE, UP TO 25 N N into APC not use this into APC rate MILLICURIES rate code for GBP, RVG or MUGA procedures see A9560

Tc99m pentetate Packaged Packaged A9539 Tc-99m DTPA N N into APC TECHNETIUM TC-99M PENTETATE, DIAGNOSTIC, PER into APC rate rate STUDY DOSE, UP TO 25 MILLICURIES Tc99m MAA Packaged Packaged A9540 TECHNETIUM TC-99M MACROAGGREGATED ALBUMIN, MAA N N into APC into APC rate DIAGNOSTIC, PER STUDY DOSE, UP TO 10 rate MILLICURIES Tc99m sulfur colloid SULFUR Packaged Packaged A9541 COLLOID® N N into APC TECHNETIUM TC-99M SULFUR COLLOID, DIAGNOSTIC, into APC rate (SC) rate PER STUDY DOSE, UP TO 20 MILLICURIES In111 ibritumomab, dx Packaged Dx In-111 Packaged A9542 N N into APC INDIUM IN-111 IBRITUMOMAB TIUXETAN, DIAGNOSTIC, ZEVALIN® into APC rate rate PER STUDY DOSE, UP TO 5 MILLICURIES Y90 ibritumomab, rx Rx Y-90 A9543 YTTRIUM Y-90 IBRITUMOMAB TIUXETAN, 1643 1643 K K $38,058.06 $42,068.81 10.5% ZEVALIN® THERAPEUTIC, PER TREATMENT DOSE, UP TO 40 MILLICURIES I131 tositumomab, dx Packaged Packaged A9544 Dx BEXXAR® N N into APC IODINE I-131 TOSITUMOMAB, DIAGNOSTIC, PER into APC rate rate STUDY DOSE I131 tositumomab, rx A9545 Rx BEXXAR® 1645 1645 K K $30,188.56 $30,085.87 -0.3% IODINE I-131 TOSITUMOMAB, THERAPEUTIC, PER TREATMENT DOSE Co57/58 Packaged Packaged A9546 NYCOMED N N into APC COBALT CO-57/58, CYANOCOBALAMIN, DIAGNOSTIC, into APC rate rate PER STUDY DOSE, UP TO 1 MICROCURIE See new codes A9570 In111 oxyquinoline Packaged and A9571 for Packaged A9547 INDIUM IN-111 OXYQUINOLINE, DIAGNOSTIC, PER 0.5 N N into APC WBC and into APC rate MILLICURIE rate Platelet Imaging In111 pentetate Packaged Packaged A9548 INDIUM IN-111 PENTETATE, DIAGNOSTIC, PER 0.5 Indium DTPA N N into APC into APC rate MILLICURIE rate

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FINAL FINAL RULE CPT/ 2013-F 2014-F 2013-F 2014-F RULE CY % Trade CY 2014 2013 Payment Payment HCPCS APC APC SI SI Change Description Name Rate Rate Tc99m gluceptate Packaged TECHNETIUM TC-99M SODIUM GLUCEPTATE, Packaged A9550 GLUCOSCAN® N N into APC DIAGNOSTIC, PER STUDY DOSE, UP TO 25 into APC rate rate MILLICURIES Tc99m succimer Packaged Packaged A9551 TECHNETIUM TC-99M SUCCIMER, DIAGNOSTIC, PER DMSA N N into APC into APC rate STUDY DOSE, UP TO 10 MILLICURIES rate

F18 fdg Packaged Packaged A9552 F-18 FDG, DIAGNOSTIC, FDG / F-18 N N into APC into APC rate PER STUDY DOSE, UP TO 45 MILLICURIES rate

Cr51 chromate Packaged Packaged A9553 CHROMIUM CR-51 SODIUM CHROMATE, DIAGNOSTIC, N N into APC into APC rate PER STUDY DOSE, UP TO 250 MICROCURIES rate

I125 iothalamate, dx Packaged IODINE I-125 SODIUM IOTHALAMATE, DIAGNOSTIC, Packaged A9554 N N into APC PER STUDY DOSE, UP TO 10 MICROCURIES into APC rate rate Rb82 rubidium Packaged Rb-82 Packaged A9555 N N into APC CardioGen82 into APC rate RUBIDIUM RB-82, DIAGNOSTIC, PER STUDY DOSE, UP rate Ga67 gallium Packaged Packaged A9556 GALLIUM GA-67 CITRATE, DIAGNOSTIC, PER GALLIUM N N into APC into APC rate MILLICURIE rate Tc99m bicisate Packaged Packaged A9557 TECHNETIUM TC-99M BICISATE, DIAGNOSTIC, PER NEUROLITE® N N into APC into APC rate STUDY DOSE, UP TO 25 MILLICURIES rate Xe133 xenon 10mci Packaged Packaged A9558 XENON XE-133 GAS, DIAGNOSTIC, PER 10 Xenon N N into APC into APC rate MILLICURIES rate Co57 cyano COBALT CO-57 CYANOCOBALAMIN, ORAL, Shillings Study Packaged Packaged A9559 DIAGNOSTIC, PER STUDY DOSE, UP TO 1 Rubratope 57 N N into APC into APC rate MICROCURIE Cobatope 57 rate

ULTRATAG® or Cold PYP + Tc99m labeled rbc 99m Tc Code TECHNETIUM TC-99M LABELED RED BLOOD CELLS, to be used for Packaged Packaged A9560 DIAGNOSTIC, PER STUDY DOSE, UP TO 30 both the N N into APC into APC rate MILLICURIES invivo/invitro rate methods of tagging Red Blood Cells Tc99m oxidronate Packaged TECHNETIUM TC-99M OXIDRONATE, DIAGNOSTIC, Packaged A9561 HDP® N N into APC PER STUDY DOSE, UP TO 30 MILLICURIES into APC rate rate Tc99m mertiatide Packaged TECHNETIUM TC-99M MERTIATIDE, DIAGNOSTIC, PER Packaged A9562 MAG-3® N N into APC STUDY DOSE, UP TO 15 MILLICURIES into APC rate rate P32 Na phosphate SODIUM PHOSPHATE P-32, THERAPEUTIC, PER A9563 1675 1675 K K $170.10 $223.07 31.1% MILLICURIE

P32 chromic phosphate Phosphocol A9564 CHROMIC PHOSPHATE P-32 SUSPENSION, 1676 1676 K K $114.95 $316.07 175.0% P-32 THERAPEUTIC, PER MILLICURIE Tc99m fanolesomab Packaged TECHNETIUM TC-99M FANOLESOMAB, DIAGNOSTIC, Packaged A9566 NeutroSpec™ N N into APC PER STUDY DOSE, UP TO 25 MILLICURIES into APC rate rate

Technetium TC-99m aerosol DTPA Aerosol Packaged TECHNETIUM TC-99M PENTETATE, DIAGNOSTIC, For Lung Packaged A9567 N N into APC AEROSOL, PER STUDY DOSE, UP TO 75 MILLICURIES Ventilation into APC rate rate Studies

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FINAL FINAL RULE CPT/ 2013-F 2014-F 2013-F 2014-F RULE CY % Trade CY 2014 2013 Payment Payment HCPCS APC APC SI SI Change Description Name Rate Rate Technetium tc99m arcitumomab Packaged Packaged A9568 TECHNETIUM TC-99M ARCITUMOMAB, DIAGNOSTIC, CEA-SCAN® N N into APC into APC rate PER STUDY DOSE, UP TO 45 MILLICURIES rate

Use this code for or Technetium TC-99m auto WBC TECHNETIUM TC-99M EXAMETAZIME LABELED Packaged imaging do not Packaged A9569 AUTOLOGOUS WHITE BLOOD CELLS, DIAGNOSTIC, N N into APC use this code into APC rate PER STUDY DOSE rate for brain imaging see A9521 When Indium In-111 auto WBC prepared with Packaged 'INDIUM IN-111 LABELED AUTOLOGOUS WHITE BLOOD patient WBC Packaged A9570 N N into APC CELLS, DIAGNOSTIC, PER STUDY DOSE use this new into APC rate rate code do not use A9547 When prepared with Indium IN-111 auto platelet patient Packaged INDIUM IN-111 LABELED AUTOLOGOUS PLATELETS, Packaged A9571 platelets use N N into APC DIAGNOSTIC, PER STUDY DOSE into APC rate this new code rate do not use A9547 A9572 Indium In-111 pentetreotide Octreoscan® Packaged CMS 'INDIUM IN-111 PENTETREOTIDE, DIAGNOSTIC, PER A9565 was Packaged N N into APC deleted STUDY DOSE, UP TO 6 MILLICURIES deleted into APC rate rate A9565 effective 2008 F-18, F-18, NaF, Packaged Packaged A9580 Sodium Fluoride F-18, diagnostic, per study dose, up to 30 Sodium N N into APC into APC rate millicuries Fluoride rate I-123 MIBG Packaged Iobenguane, I-123, diagnostic, per study dose, up to 15 AdreView Packaged A9582 N N into APC millicuries NDC 17156- into APC rate rate 0235-01 DaTscan® Iodine I-123 , diagnostic, per study dose, (up to 5 Packaged A9584 NDC #17156- G N $1,974.93 millicuries) into APC rate 210-01 F18 Packaged FLORBETAPIR F18, DIAGNOSTIC, PER STUDY DOSE, Amyvid™ NDC Packaged A9586 E N into APC UP TO 10 MILLICURIES #0002-1200-01 into APC rate rate Vizamyl™ NDC # 17156- Packaged A9599 Radiopha dx beta amyloid pet N 067-10 or # into APC rate 17156-067-30 Sr89 strontium Rx STRONTIUM SR-89 CHLORIDE, THERAPEUTIC, PER A9600 METASTRON 0701 701 K K $1,071.86 $1,368.27 27.7% MILLICURIE ®

Sm 153 lexidronm Rx SAMARIUM SM-153 LEXIDRONAMM, THERAPEUTIC, A9604 QUADRAMET 1295 1295 K K $7,919.26 $7,919.26 0.0% PER TREATMENT DOSE, up to 150 MILLICURIES ®

Radiopharm rx agent noc Packaged RADIOPHARMACEUTICAL, THERAPEUTIC, NOT Packaged A9699 RX NOC N N into APC OTHERWISE CLASSIFIED into APC rate rate LymphoSeek Technetium Tc 99m tilmanocept, diagnostic, up to 0.5 C2104 ™ Deleted, 1463 Deleted G Deleted $5,578.78 Deleted millicuries see A9520 Xofigo™ NDC Provide Provide C9399 Radium Ra-223 dichloride, therapeutic, per treatment dose #50419-0208- A Invoice Invoice 01 **Note final payment rates for status G codes have offset RP amounts posted on the CMS web site by CPT code. Injection adenosine 6 mg Injection Adenosine for therapeutic use, 6 mg (not to be Packaged Packaged J0150 used to report any adenosine phosphate compounds, ADENOCARD N N into APC into APC rate instead use A9270) rate

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FINAL FINAL RULE CPT/ 2013-F 2014-F 2013-F 2014-F RULE CY % Trade CY 2014 2013 Payment Payment HCPCS APC APC SI SI Change Description Name Rate Rate ● J0151 ADENOSCAN Packaged Packaged NEW Inj adenosine diag 1 milligram Replaces N into APC into APC rate 2014 J0152 rate Adenosine injection, 30 mg ADENOSCAN Injection Adenosine for diagnostic use, 30 mg (not to be J0152 Deleted, See 0917 Deleted K D $109.40 Deleted used to report any adenosine phosphate compounds, J0151 instead use A9270) Packaged Packaged J0280 Aminophyllin up to 250 MG, inj. N N into APC into APC rate Packaged Packaged J0461 Inj, atropine sulfate, 0.01 mg N N into APC into APC rate Packaged Packaged J1120 Acetazolamide sodium injection, up to 500 mg Diamox N N into APC into APC rate Packaged Packaged J1160 Inj, digoxin, up to 0.5 mg Lanoxin N N into APC into APC rate Packaged Packaged J1245 Dipyridamole injection, per 10mg Persantine IV N N into APC into APC rate Packaged Packaged J1250 Inj dobutamine HCL/250 mg Dobutrex N N into APC into APC rate Packaged Packaged J1265 Injection, dopamine HCl, 40 mg Intropin N N into APC into APC rate J1610 hydrochloride per 1MG Glucagen 9042 9042 K K $111.23 $127.98 15.1% Packaged Packaged J1800 Propranolol HCL injection, up to 1 mg Inderal N N into APC into APC rate Packaged Packaged J1940 Furosemide injection up to 20 mg Lasix N N into APC into APC rate Packaged Packaged J2270 Morphine sulfate injection, up to 10 mg N N into APC into APC rate Packaged Packaged J2271 Morphine sulfate injection, 100 mg N N into APC into APC rate LexiScan NDC Packaged J2785 Injection, Regadenoson, 0.1 milligrams 00469-6501- K N $53.67 into APC rate 89 Packaged Sincalide injection Packaged J2805 Kinevac® N N into APC INJECTION, SINCALIDE, 5 MICROGRAMS into APC rate rate Thyrogen J3240 Thyrotropin injection 0.9 mg n 1.1 mg vial 9108 9108 K K $1,053.79 $1,212.34 15.0% Thytropar Packaged Packaged J3420 Injection, vitamin B-12 cyanocobalamin, up to 1000 mcg N N into APC into APC rate rate Packaged Packaged J3490 Drugs Unclassified injection NOC N N into APC into APC rate rate Packaged Packaged J3590 Unclassified biologics NOC N N into APC into APC rate rate Packaged Packaged J7030 Normal saline solution infus (1000 CC) N N into APC into APC rate rate Packaged Packaged J7040 Normal saline solution infus (500ML=1) N N into APC into APC rate rate Packaged Packaged J7050 Normal saline solution infus (250 CC) N N into APC into APC rate rate J9310 Rituximab, 100 mg RituXan 0849 849 K K $659.72 $678.70 2.9% Non Admin + supply, tositumomab, 450 mg Radioactive G3001 0442 442 S S $1,962.50 $1,822.34 -7.1% (Use this Code for Bexxar) Bexxar Plus Injection Injection, non-radioactive, non-contrast, visualization Packaged Q9968 Methylene Blue K N $1.77 adjunct (e.g., Methylene Blue, Isosulfan Blue), 1mg into APC rate

Disclaimer The opinions referenced are those of the members of the SNMMI Coding and Reimbursement Committee and their consultants based on their coding experience. They are based on the commonly used codes in Nuclear Medicine, which are not all inclusive. Always check with your local insurance carriers as policies vary by region. The final decision for the coding of a procedure must be made by the physician considering regulations of insurance carriers and any local, state or federal laws that apply to the physicians practice. The SNMMI and its representatives disclaim any liability arising from the use of these opinions.

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