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0820T Mntr psychdlc med 1stphy/qhp

What 0820T is

CMS fee schedule short descriptor: Mntr psychdlc med 1stphy/qhp.

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 0820T (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.

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Medically Unlikely Edit (MUE)

Medicare caps 0820T at 6 units per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Nature of Service/Procedure. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 0820T? These codes are bundled into it

0820T is a Column 1 code in 3 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 codeShort descriptionModifier indicator
36591Draw blood off venous device0 - no modifier bypassCheck pair
36592Collect blood from picc0 - no modifier bypassCheck pair
96523Irrig drug delivery device0 - no modifier bypassCheck pair

0820T is bundled into these codes

0820T appears as a Column 2 code in 20 active edits. Reported with one of these Column 1 codes on the same date of service, 0820T is the code that denies.

Column 1 codeShort descriptionModifier indicator
90832Psytx w pt 30 minutes0Check pair
90833Psytx w pt w e/m 30 min0Check pair
90834Psytx w pt 45 minutes0Check pair
90836Psytx w pt w e/m 45 min0Check pair
90837Psytx w pt 60 minutes0Check pair
90838Psytx w pt w e/m 60 min0Check pair
90839Psytx crisis initial 60 min0Check pair
90840Psytx crisis ea addl 30 min0Check pair
96116Nubhvl xm phys/qhp 1st hr0Check pair
96121Nubhvl xm phy/qhp ea addl hr0Check pair
97151Bhv id assmt by phys/qhp0Check pair
97152Bhv id suprt assmt by 1 tech0Check pair
97153Adaptive behavior tx by tech0Check pair
97154Grp adapt bhv tx by tech0Check pair
97155Adapt behavior tx phys/qhp0Check 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.