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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.

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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 codeShort descriptionModifier indicator
00142Anes px on eye lens surgery0 - no modifier bypassCheck pair
00144Anes px eye corneal trnspl0 - no modifier bypassCheck pair
00145Anes px eye vitreortnl surg0 - no modifier bypassCheck pair
00147Anes px on eye iridectomy0 - no modifier bypassCheck pair
00148Anes px eye ophthalmoscopy0 - no modifier bypassCheck pair
0101TEsw muscskel sys nos1 - modifier may bypassCheck pair
0102TEsw phy anes lat hmrl epcndl1 - modifier may bypassCheck pair
0213TNjx paravert w/us cer/thor0 - no modifier bypassCheck pair
0216TNjx paravert w/us lumb/sac0 - no modifier bypassCheck pair
0512TEsw integ wnd hlg 1st wnd1 - modifier may bypassCheck pair
0708TId ca immntx prep & 1st njx1 - modifier may bypassCheck pair
12001Rpr s/n/ax/gen/trnk 2.5cm/<1 - modifier may bypassCheck pair
12002Rpr s/n/ax/gen/trnk2.6-7.5cm1 - modifier may bypassCheck pair
12004Rpr s/n/ax/gen/trk7.6-12.5cm1 - modifier may bypassCheck pair
12005Rpr s/n/a/gen/trk12.6-20.0cm1 - modifier may bypassCheck pair
12006Rpr s/n/a/gen/trk20.1-30.0cm1 - modifier may bypassCheck pair
12007Rpr s/n/ax/gen/trnk >30.0 cm1 - modifier may bypassCheck pair
12011Rpr f/e/e/n/l/m 2.5 cm/<1 - modifier may bypassCheck pair
12013Rpr f/e/e/n/l/m 2.6-5.0 cm1 - modifier may bypassCheck pair
12014Rpr f/e/e/n/l/m 5.1-7.5 cm1 - modifier may bypassCheck pair
12015Rpr f/e/e/n/l/m 7.6-12.5 cm1 - modifier may bypassCheck pair
12016Rpr fe/e/en/l/m 12.6-20.0 cm1 - modifier may bypassCheck pair
12017Rpr fe/e/en/l/m 20.1-30.0 cm1 - modifier may bypassCheck pair
12018Rpr f/e/e/n/l/m >30.0 cm1 - modifier may bypassCheck pair
12020Tx supfc wnd dehsn smpl clsr1 - modifier may bypassCheck pair
12021Tx supfc wnd dehsn w/packing1 - modifier may bypassCheck pair
12031Intmd rpr s/a/t/ext 2.5 cm/<1 - modifier may bypassCheck pair
12032Intmd rpr s/a/t/ext 2.6-7.51 - modifier may bypassCheck pair
12034Intmd rpr s/tr/ext 7.6-12.51 - modifier may bypassCheck pair
12035Intmd rpr s/a/t/ext 12.6-201 - modifier may bypassCheck 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 codeShort descriptionModifier indicator
97037Appl modality 1+lllt po pain1Check pair
97597Dbrdmt opn wnd 1st 20 cm/<1Check pair
97605Neg prs wnd ther dme<=50sqcm1Check pair
97606Neg prs wnd ther dme>50 sqcm1Check pair
97607Neg prs wnd thr ndme<=50sqcm1Check pair
97608Neg prs wnd ther ndme>50sqcm1Check pair
G0245Initial foot exam pt lops1Check pair
G0246Followup eval of foot pt lop1Check pair
G0247Routine footcare pt w lops1Check 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.