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.
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 code | Short description | Modifier indicator | |
|---|---|---|---|
0403T | Diabetes prev standard curr | 1 - modifier may bypass | Check pair |
0488T | Diabetes prev online/elec | 1 - modifier may bypass | Check pair |
0820T | Mntr psychdlc med 1stphy/qhp | 0 - no modifier bypass | Check pair |
0890T | Arhfcmrigtbs 1st tx day | 1 - modifier may bypass | Check pair |
0891T | Arhfcmrigtbs sbsq tx day | 1 - modifier may bypass | Check pair |
0892T | Arhfcmrigtbs sbsq per tx day | 1 - modifier may bypass | Check pair |
36591 | Draw blood off venous device | 0 - no modifier bypass | Check pair |
36592 | Collect blood from picc | 0 - no modifier bypass | Check pair |
90867 | Tcranial magn stim tx plan | 0 - no modifier bypass | Check pair |
90868 | Tcranial magn stim tx deli | 0 - no modifier bypass | Check pair |
90869 | Tcran magn stim redetemine | 0 - no modifier bypass | Check pair |
90889 | Preparation of report | 0 - no modifier bypass | Check pair |
96160 | Pt-focused hlth risk assmt | 1 - modifier may bypass | Check pair |
96161 | Caregiver health risk assmt | 1 - modifier may bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check 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 code | Short description | Modifier indicator | |
|---|---|---|---|
0362T | Bhv id suprt assmt ea 15 min | 1 | Check pair |
0889T | Prsnlz trgt dvl arhfcmrigtbs | 1 | Check pair |
90785 | Psytx complex interactive | 0 | Check pair |
90791 | Psych diagnostic evaluation | 0 | Check pair |
90792 | Psych diag eval w/med srvcs | 0 | Check pair |
90832 | Psytx w pt 30 minutes | 0 | Check pair |
90833 | Psytx w pt w e/m 30 min | 0 | Check pair |
90834 | Psytx w pt 45 minutes | 0 | Check pair |
90836 | Psytx w pt w e/m 45 min | 0 | Check pair |
90837 | Psytx w pt 60 minutes | 0 | Check pair |
90838 | Psytx w pt w e/m 60 min | 0 | Check pair |
90839 | Psytx crisis initial 60 min | 0 | Check pair |
90840 | Psytx crisis ea addl 30 min | 0 | Check pair |
90845 | Psychoanalysis | 0 | Check pair |
90846 | Family psytx w/o pt 50 min | 0 | 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.