0604T Rem oct rta dev setup&educaj
What 0604T is
CMS fee schedule short descriptor: Rem oct rta dev setup&educaj.
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 0604T (CY2026)
This code has no Physician Fee Schedule rate: Carrier-priced - the Medicare contractor sets the price. 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 0604T 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 0604T? These codes are bundled into it
0604T is a Column 1 code in 16 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.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
0733T | Rem r-t mtn nrehab ther sply | 1 - modifier may bypass | Check pair |
0734T | Rem r-t mtn nrehab tx mgmt | 1 - modifier may bypass | Check pair |
36591 | Draw blood off venous device | 0 - no modifier bypass | Check pair |
36592 | Collect blood from picc | 0 - no modifier bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
98975 | Rtm 1st set-up&pt educaj eqp | 1 - modifier may bypass | Check pair |
98976 | Rtm dev sply resp sys 16-30d | 1 - modifier may bypass | Check pair |
98977 | Rtm dev sply mscskl 16-30 d | 1 - modifier may bypass | Check pair |
98980 | Rtm tx mgmt 1st 20 min | 1 - modifier may bypass | Check pair |
98981 | Rtm tx mgmt ea addl 20 min | 1 - modifier may bypass | Check pair |
99091 | Collj & interpj data ea 30 d | 1 - modifier may bypass | Check pair |
99453 | Rem mntr physiol param setup | 1 - modifier may bypass | Check pair |
99454 | Rem mntr physiol param 16-30 | 1 - modifier may bypass | Check pair |
99457 | Rpm tx mgmt 1st 20 min | 1 - modifier may bypass | Check pair |
99458 | Rpm tx mgmt ea addl 20 min | 1 - modifier may bypass | Check pair |
G0248 | Demonstrate use home inr mon | 1 - modifier may bypass | Check pair |
0604T is bundled into these codes
0604T appears as a Column 2 code in 4 active edits. Reported with one of these Column 1 codes on the same date of service, 0604T is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
0730T | Trabeculotomy lsr w/oct gdn | 0 | Check pair |
92134 | Cptrz oph dx img pst sgm rta | 0 | Check pair |
92227 | Img rta detcj/mntr ds staff | 0 | Check pair |
92228 | Img rta detc/mntr ds phy/qhp | 0 | Check pair |
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.