CPT 2026 · Anesthesia

CPT 01996

Global XXX

Dly hosp mgmt edrl rx admin

Effective 2026-04-01 Conv. factor $33.4009

ASA base units

Payment Methodology

Status Indicator

NCCI Partners

XXX

Global Period

ASA base units

Anesthesia codes are not paid on the Physician Fee Schedule RVU system. Medicare calculates payment as (base units + time units + modifier units) × anesthesia conversion factor. See the CMS Anesthesiologists Center for the current base unit and conversion factor values.

CPT 01996 Billing & Documentation Guide

CPT code 01996 (Dly hosp mgmt edrl rx admin) is classified under Anesthesia with a global period indicator of XXX. This code uses the ASA base units payment methodology rather than standard RVU-based Physician Fee Schedule pricing. Refer to the methodology notice above for billing implications.

When billing 01996, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 01996 with related codes; this code has 10 PTP bundling relationships on file (see table below).

Payment Status & Global Period

CMS Status Indicator

Status not specified

Global Period

XXX

No global period (E/M and other non-procedural services)

MUE Limit (Medically Unlikely Edits)

Max units per beneficiary per date of service

Rationale: Code Descriptor / CPT Instruction

Adjudication: Date of Service (Policy)

Source: CMS NCCI MUE Practitioner Services, effective 2026-04-01.

Submitting more than 1 units of 01996 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.

NCCI Bundling Edits, CPT 01996

Procedure-to-procedure (PTP) edits. If you bill any of these codes with 01996 on the same date of service, review the modifier indicator and payer policy before submission.

Partner Code	Relationship	Modifier Allowed	Rationale
36591	Column 1 (primary), can be billed with modifier	No	CPT Manual or CMS manual coding instruction
36592	Column 1 (primary), can be billed with modifier	No	CPT Manual or CMS manual coding instruction
93312	Column 1 (primary), can be billed with modifier	Yes	Standard preparation/monitoring services for anesthesia
93313	Column 1 (primary), can be billed with modifier	Yes	Standard preparation/monitoring services for anesthesia
93561	Column 1 (primary), can be billed with modifier	No	Standard preparation/monitoring services for anesthesia
93562	Column 1 (primary), can be billed with modifier	No	Standard preparation/monitoring services for anesthesia
93598	Column 1 (primary), can be billed with modifier	No	Standard preparation/monitoring services for anesthesia
93701	Column 1 (primary), can be billed with modifier	No	Standard preparation/monitoring services for anesthesia
96523	Column 1 (primary), can be billed with modifier	No	CPT Manual or CMS manual coding instruction
99143	Column 1 (primary), can be billed with modifier	No	HCPCS/CPT procedure code definition

Frequently Asked Questions, CPT 01996

What does CPT code 01996 mean? +

CPT code 01996 represents: Dly hosp mgmt edrl rx admin. It's in the Anesthesia category with a global period of XXX.

What is the Medicare reimbursement for CPT 01996? +

What modifiers can I use with CPT 01996? +

Anesthesia codes use a distinct modifier set: AA (personally performed), QK/QY/QX (medical direction variants), QZ (CRNA without medical direction), AD (supervising > 4 rooms), G8/G9 (monitored anesthesia care), and ASA physical status P1-P6. Standard surgical modifiers like 50, 51, 59 do not apply.

What bundling edits apply to CPT 01996? +

This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.