98978 Rtm dev sply cbt 16-30 d
What 98978 is
CMS fee schedule short descriptor: Rtm dev sply cbt 16-30 d.
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 98978 (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 98978 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 98978? These codes are bundled into it
98978 is a Column 1 code in 25 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 |
96158 | Hlth bhv ivntj indiv 1st 30 | 1 - modifier may bypass | Check pair |
96159 | Hlth bhv ivntj indiv ea addl | 1 - modifier may bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
98975 | Rtm 1st set-up&pt educaj eqp | 0 - no modifier bypass | Check pair |
98976 | Rtm dev sply resp sys 16-30d | 0 - no modifier bypass | Check pair |
98977 | Rtm dev sply mscskl 16-30 d | 0 - no modifier bypass | Check pair |
99091 | Collj & interpj data ea 30 d | 0 - no modifier bypass | Check pair |
99424 | Prin care mgmt phys 1st 30 | 0 - no modifier bypass | Check pair |
99425 | Prin care mgmt phys ea addl | 0 - no modifier bypass | Check pair |
99426 | Prin care mgmt staff 1st 30 | 0 - no modifier bypass | Check pair |
99427 | Prin care mgmt staff ea addl | 0 - no modifier bypass | Check pair |
99437 | Chrnc care mgmt phys ea addl | 0 - no modifier bypass | Check pair |
99439 | Chrnc care mgmt staf ea addl | 0 - no modifier bypass | Check pair |
99453 | Rem mntr physiol param setup | 0 - no modifier bypass | Check pair |
99454 | Rem mntr physiol param 16-30 | 0 - no modifier bypass | Check pair |
99457 | Rpm tx mgmt 1st 20 min | 0 - no modifier bypass | Check pair |
99458 | Rpm tx mgmt ea addl 20 min | 0 - no modifier bypass | Check pair |
99484 | Care mgmt svc bhvl hlth cond | 0 - no modifier bypass | Check pair |
99492 | 1st psyc collab care mgmt | 0 - no modifier bypass | Check pair |
99493 | Sbsq psyc collab care mgmt | 0 - no modifier bypass | Check pair |
99494 | 1st/sbsq psyc collab care | 0 - no modifier bypass | Check pair |
G0248 | Demonstrate use home inr mon | 0 - no modifier bypass | Check pair |
G0250 | Md inr test revie inter mgmt | 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.