Nov. 24, 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:
- CPCP018 Revenue Codes Requiring Supporting CPT, HCPCS, and/or NDC Codes - Outpatient Facility Claims, effective Oct. 31, 2025
- CPCP029 Medical Record Documentation, effective Oct. 31, 2025
- CPCP032 Intraoperative Neurophysiology Monitoring (IONM) Policy, effective Oct. 31, 2025
- CPCP036 Paravertebral Facet Injection Procedure Billing and Coding Policy, effective Nov. 21, 2025
- CPCP040 Physical Medicine and Rehabilitation Services, effective Nov. 7, 2025
- CPCP042 Emergency Department Services Evaluation and Management - (E/M) Coding - Professional Services, effective Nov. 7, 2025
CPT copyright 2024 American Medical Association. All rights reserved. CPT is a registered trademark of the AMA.
Clinical payment and coding policies are based on using healthcare professionals and industry standard guidelines. The clinical payment and coding guidelines are not intended to provide billing or coding advice but to serve as a reference for facilities and providers.