Clinical Payment and Coding Policy Updates

April 28, 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:

  • CPCP013 Increased Procedural Services, Modifier 22-Professional Provider effective April 15, 2025
  • CPCP014 Global Surgical Package-Professional Provider effective April 15, 2025
  • CPCP009 Co-Surgeon/Team Surgeon Policy-Professional Provider effective April 18, 2025
  • CPCP015 Multiple Surgical Procedures-Professional Provider effective April 23, 2025
  • CPCP019 Infusion Services effective July 18, 2025

CPT copyright 2025 American Medical Association. All rights reserved. CPT is a registered trademark of the AMA. 

Clinical payment and coding policies are based on health care professional 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.