Sept. 23, 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. These policies are not intended to address all coding or 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:
- CPCP001 Observation Services Policy, effective Dec. 22, 2025
- CPCP006 Preventive Services, effective Oct. 1, 2025
- CPCP021 Laboratory Panel Billing, effective Sept. 22, 2025
CPCP026 Therapeutic, Prophylactic, Diagnostic, Injection and Infusion Administration Coding, effective Sept. 26, 2025 - CPCP028 Non-Reimbursable EIU Services Code List, effective Sept. 15, 2025
- CPCP051 Psychiatry/Psychotherapy Services- Professional Provider, effective Dec. 22, 2025
- CPCP033 Telemedicine and Telehealth/Virtual Health Care Services Policy, effective Sept. 26, 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.