96910 Photchmtx tar&uvb/ptrltm&uvb
What 96910 is
CMS fee schedule short descriptor: Photchmtx tar&uvb/ptrltm&uvb.
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 96910 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 0.00 | 3.42 | 0.02 | 3.44 | $114.90 |
| Facility (hospital, ASC) | 0.00 | 3.42 | 0.02 | 3.44 | $114.90 |
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 96910 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: Nature of Service/Procedure. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 96910? These codes are bundled into it
96910 is a Column 1 code in 12 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 |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
96912 | Photochemotherapy puva | 1 - modifier may bypass | Check pair |
96913 | Photochemotx sev dermatoses | 1 - modifier may bypass | Check pair |
97028 | Ultraviolet therapy | 0 - no modifier bypass | Check pair |
99211 | Off/op est may x req phy/qhp | 0 - no modifier bypass | Check pair |
99212 | Office o/p est sf 10 min | 1 - modifier may bypass | Check pair |
99213 | Office o/p est low 20 min | 1 - modifier may bypass | Check pair |
99214 | Office o/p est mod 30 min | 1 - modifier may bypass | Check pair |
99215 | Office o/p est hi 40 min | 1 - modifier may bypass | Check pair |
G0463 | Hospital outpt clinic visit | 1 - modifier may bypass | Check pair |
96910 is bundled into these codes
96910 appears as a Column 2 code in 4 active edits. Reported with one of these Column 1 codes on the same date of service, 96910 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
0906T | Coms ther 1st appl<=50 sq cm | 1 | Check pair |
96567 | Pdt dstr prmlg les skn | 1 | Check pair |
96573 | Pdt dstr prmlg les phys/qhp | 1 | Check pair |
96574 | Dbrdmt prmlg les w/pdt | 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.