01996 Dly hosp mgmt edrl rx admin

What 01996 is

CMS fee schedule short descriptor: Dly hosp mgmt edrl rx admin.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 01996 (CY2026)

This code has no Physician Fee Schedule rate: Anesthesia service with no RVUs in the standard file. It may be paid under a different fee schedule (clinical laboratory, DMEPOS, anesthesia) or not paid at all - check the relevant CMS schedule.

Medically Unlikely Edit (MUE)

Medicare caps 01996 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 01996? These codes are bundled into it

01996 is a Column 1 code in 21 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

01996 is bundled into these codes

01996 appears as a Column 2 code in 289 active edits. Reported with one of these Column 1 codes on the same date of service, 01996 is the code that denies.

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.