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97152 Bhv id suprt assmt by 1 tech

What 97152 is

CMS fee schedule short descriptor: Bhv id suprt assmt by 1 tech.

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 97152 (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 97152 at 16 units 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: Clinical: CMS Workgroup. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 97152? These codes are bundled into it

97152 is a Column 1 code in 15 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
0403TDiabetes prev standard curr1 - modifier may bypassCheck pair
0488TDiabetes prev online/elec1 - modifier may bypassCheck pair
0820TMntr psychdlc med 1stphy/qhp0 - no modifier bypassCheck pair
0890TArhfcmrigtbs 1st tx day1 - modifier may bypassCheck pair
0891TArhfcmrigtbs sbsq tx day1 - modifier may bypassCheck pair
0892TArhfcmrigtbs sbsq per tx day1 - modifier may bypassCheck pair
36591Draw blood off venous device0 - no modifier bypassCheck pair
36592Collect blood from picc0 - no modifier bypassCheck pair
90867Tcranial magn stim tx plan0 - no modifier bypassCheck pair
90868Tcranial magn stim tx deli0 - no modifier bypassCheck pair
90869Tcran magn stim redetemine0 - no modifier bypassCheck pair
90889Preparation of report0 - no modifier bypassCheck pair
96160Pt-focused hlth risk assmt1 - modifier may bypassCheck pair
96161Caregiver health risk assmt1 - modifier may bypassCheck pair
96523Irrig drug delivery device0 - no modifier bypassCheck pair

97152 is bundled into these codes

97152 appears as a Column 2 code in 67 active edits. Reported with one of these Column 1 codes on the same date of service, 97152 is the code that denies.

Column 1 codeShort descriptionModifier indicator
0362TBhv id suprt assmt ea 15 min1Check pair
0889TPrsnlz trgt dvl arhfcmrigtbs1Check pair
90785Psytx complex interactive0Check pair
90791Psych diagnostic evaluation0Check pair
90792Psych diag eval w/med srvcs0Check pair
90832Psytx w pt 30 minutes0Check pair
90833Psytx w pt w e/m 30 min0Check pair
90834Psytx w pt 45 minutes0Check pair
90836Psytx w pt w e/m 45 min0Check pair
90837Psytx w pt 60 minutes0Check pair
90838Psytx w pt w e/m 60 min0Check pair
90839Psytx crisis initial 60 min0Check pair
90840Psytx crisis ea addl 30 min0Check pair
90845Psychoanalysis0Check pair
90846Family psytx w/o pt 50 min0Check 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.