Aug. 25, 2025
Clinical Payment and Coding Policies describe payment rules and methodologies for Current Procedural Terminology (CPT®) codes, Healthcare Common Procedure Coding System and ICD-10 coding for claims submitted as covered services. This information is a resource for our payment policies. It’s not intended to address all reimbursement-related issues. We regularly add and modify clinical payment and coding policy positions as part of our ongoing policy review process.
The following policies were updated:
- CPCP004 Neonatal Intensive Care Unit Level of Care Authorization and Reimbursement Policy, effective Aug. 25, 2025
- CPCP022 Pneumatic Compression Devices, effective Oct. 31, 2025
- CPCP023 Modifier Reference Policy, effective Oct. 31, 2025
- CPCP017 Wasted/Discarded Drugs and Biologicals Policy, effective Nov. 25, 2025
- CPCP012 Hernia Repair, effective Nov. 25, 2025
View the policies.
CPT copyright 2024 American Medical Association. All rights reserved. CPT is a registered trademark of the AMA.
The information provided does not constitute coding or legal advice. Physicians and other health care providers should use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment, and to submit claims using the most appropriate code(s) based upon the medical record documentation, coding guidelines and reference materials.