96004 Phys review of motion tests
What 96004 is
CMS fee schedule short descriptor: Phys review of motion tests.
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 96004 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 2.09 | 0.95 | 0.14 | 3.18 | $106.21 |
| Facility (hospital, ASC) | 2.09 | 0.95 | 0.14 | 3.18 | $106.21 |
National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.
Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply.
Medically Unlikely Edit (MUE)
Medicare caps 96004 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 96004? These codes are bundled into it
96004 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 code | Short description | Modifier indicator | |
|---|---|---|---|
36591 | Draw blood off venous device | 0 - no modifier bypass | Check pair |
36592 | Collect blood from picc | 0 - no modifier bypass | Check pair |
95860 | Needle emg 1 extremity | 1 - modifier may bypass | Check pair |
95861 | Needle emg 2 extremities | 1 - modifier may bypass | Check pair |
95863 | Needle emg 3 extremities | 1 - modifier may bypass | Check pair |
95864 | Needle emg 4 extremities | 1 - modifier may bypass | Check pair |
95865 | Needle emg larynx | 1 - modifier may bypass | Check pair |
95866 | Needle emg hemidiaphragm | 1 - modifier may bypass | Check pair |
95869 | Ndl emg thrc paraspinal musc | 1 - modifier may bypass | Check pair |
95870 | Ndl emg lmtd std musc 1 xtr | 1 - modifier may bypass | Check pair |
95872 | Ndl emg single fiber eltrd | 1 - modifier may bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
97116 | Gait training therapy | 1 - modifier may bypass | Check pair |
97750 | Physical performance test | 1 - modifier may bypass | 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.