0936T Photobiomodulation ther rta
What 0936T is
CMS fee schedule short descriptor: Photobiomodulation ther rta.
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 0936T (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 0936T at 1 unit 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: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 0936T? These codes are bundled into it
0936T is a Column 1 code in 189 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 | |
|---|---|---|---|
00142 | Anes px on eye lens surgery | 0 - no modifier bypass | Check pair |
00144 | Anes px eye corneal trnspl | 0 - no modifier bypass | Check pair |
00145 | Anes px eye vitreortnl surg | 0 - no modifier bypass | Check pair |
00147 | Anes px on eye iridectomy | 0 - no modifier bypass | Check pair |
00148 | Anes px eye ophthalmoscopy | 0 - no modifier bypass | Check pair |
0101T | Esw muscskel sys nos | 1 - modifier may bypass | Check pair |
0102T | Esw phy anes lat hmrl epcndl | 1 - modifier may bypass | Check pair |
0213T | Njx paravert w/us cer/thor | 0 - no modifier bypass | Check pair |
0216T | Njx paravert w/us lumb/sac | 0 - no modifier bypass | Check pair |
0512T | Esw integ wnd hlg 1st wnd | 1 - modifier may bypass | Check pair |
0708T | Id ca immntx prep & 1st njx | 1 - modifier may bypass | Check pair |
12001 | Rpr s/n/ax/gen/trnk 2.5cm/< | 1 - modifier may bypass | Check pair |
12002 | Rpr s/n/ax/gen/trnk2.6-7.5cm | 1 - modifier may bypass | Check pair |
12004 | Rpr s/n/ax/gen/trk7.6-12.5cm | 1 - modifier may bypass | Check pair |
12005 | Rpr s/n/a/gen/trk12.6-20.0cm | 1 - modifier may bypass | Check pair |
12006 | Rpr s/n/a/gen/trk20.1-30.0cm | 1 - modifier may bypass | Check pair |
12007 | Rpr s/n/ax/gen/trnk >30.0 cm | 1 - modifier may bypass | Check pair |
12011 | Rpr f/e/e/n/l/m 2.5 cm/< | 1 - modifier may bypass | Check pair |
12013 | Rpr f/e/e/n/l/m 2.6-5.0 cm | 1 - modifier may bypass | Check pair |
12014 | Rpr f/e/e/n/l/m 5.1-7.5 cm | 1 - modifier may bypass | Check pair |
12015 | Rpr f/e/e/n/l/m 7.6-12.5 cm | 1 - modifier may bypass | Check pair |
12016 | Rpr fe/e/en/l/m 12.6-20.0 cm | 1 - modifier may bypass | Check pair |
12017 | Rpr fe/e/en/l/m 20.1-30.0 cm | 1 - modifier may bypass | Check pair |
12018 | Rpr f/e/e/n/l/m >30.0 cm | 1 - modifier may bypass | Check pair |
12020 | Tx supfc wnd dehsn smpl clsr | 1 - modifier may bypass | Check pair |
12021 | Tx supfc wnd dehsn w/packing | 1 - modifier may bypass | Check pair |
12031 | Intmd rpr s/a/t/ext 2.5 cm/< | 1 - modifier may bypass | Check pair |
12032 | Intmd rpr s/a/t/ext 2.6-7.5 | 1 - modifier may bypass | Check pair |
12034 | Intmd rpr s/tr/ext 7.6-12.5 | 1 - modifier may bypass | Check pair |
12035 | Intmd rpr s/a/t/ext 12.6-20 | 1 - modifier may bypass | Check pair |
Showing 30 of 189 column 2 codes. Use the pair checker for any specific combination.
0936T is bundled into these codes
0936T appears as a Column 2 code in 9 active edits. Reported with one of these Column 1 codes on the same date of service, 0936T is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
97037 | Appl modality 1+lllt po pain | 1 | Check pair |
97597 | Dbrdmt opn wnd 1st 20 cm/< | 1 | Check pair |
97605 | Neg prs wnd ther dme<=50sqcm | 1 | Check pair |
97606 | Neg prs wnd ther dme>50 sqcm | 1 | Check pair |
97607 | Neg prs wnd thr ndme<=50sqcm | 1 | Check pair |
97608 | Neg prs wnd ther ndme>50sqcm | 1 | Check pair |
G0245 | Initial foot exam pt lops | 1 | Check pair |
G0246 | Followup eval of foot pt lop | 1 | Check pair |
G0247 | Routine footcare pt w lops | 1 | 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.