Home / Medicare fees / 0926T

0926T Prgrmg dev eval ccm-d ip

What 0926T is

CMS fee schedule short descriptor: Prgrmg dev eval ccm-d ip.

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 0926T (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.

Advertisement

Medically Unlikely Edit (MUE)

Medicare caps 0926T 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 0926T? These codes are bundled into it

0926T is a Column 1 code in 14 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
0919TRmvl perm ccm-d sys pg only0 - no modifier bypassCheck pair
0920TRmvl perm ccm-d sys 1 pac ld0 - no modifier bypassCheck pair
0921TRmvl perm ccm-d sys 1 dfb ld0 - no modifier bypassCheck pair
0922TRmvl perm ccm-d sys dual ld0 - no modifier bypassCheck pair
93268Ecg record/review1 - modifier may bypassCheck pair
93270Remote 30 day ecg rev/report1 - modifier may bypassCheck pair
93271Ecg/monitoring and analysis1 - modifier may bypassCheck pair
93272Ecg/review interpret only1 - modifier may bypassCheck pair
99446Ntrprof ph1/ntrnet/ehr 5-100 - no modifier bypassCheck pair
99447Ntrprof ph1/ntrnet/ehr 11-200 - no modifier bypassCheck pair
99448Ntrprof ph1/ntrnet/ehr 21-300 - no modifier bypassCheck pair
99449Ntrprof ph1/ntrnet/ehr 31/>0 - no modifier bypassCheck pair
99451Ntrprof ph1/ntrnet/ehr 5/>0 - no modifier bypassCheck pair
99452Ntrprof ph1/ntrnet/ehr rfrl0 - no modifier bypassCheck pair

0926T is bundled into these codes

0926T appears as a Column 2 code in 90 active edits. Reported with one of these Column 1 codes on the same date of service, 0926T is the code that denies.

Column 1 codeShort descriptionModifier indicator
0408TInsj/rplc cardiac modulj sys0Check pair
0409TInsj/rplc car modulj pls gn0Check pair
0410TInsj/rplc car modulj atr elt0Check pair
0411TInsj/rplc car modulj vnt elt0Check pair
0412TRmvl cardiac modulj pls gen0Check pair
0413TRmvl car modulj tranvns elt0Check pair
0414TRmvl & rpl car modulj pls gn0Check pair
0415TRepos car modulj tranvns elt0Check pair
0416TReloc skin pocket pls gen1Check pair
0525TInsj/rplcmt compl iims1Check pair
0526TInsj/rplcmt iims eltrd only1Check pair
0527TInsj/rplcmt iims implt mntr1Check pair
0530TRemoval complete iims1Check pair
0531TRemoval iims electrode only1Check pair
0532TRemoval iims implt mntr only1Check 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.