CPT 0509T
Global XXX ActivePattern erg w/i&r
This is a Category III emerging-technology or data-collection code. Category III codes typically have no national RVU. Payment is carrier-priced or often non-covered; verify coverage with the specific payer before billing.
CPT 0509T Billing & Documentation Guide
CPT code 0509T (Pattern erg w/i&r) is classified under Category III (Emerging Technology) with a global period indicator of XXX. This code uses the Category III (emerging technology) payment methodology rather than standard RVU-based Physician Fee Schedule pricing. Refer to the methodology notice above for billing implications.
When billing 0509T, 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 0509T with related codes; this code has 9 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 0509T for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
2026 Medicare Reimbursement by State, CPT 0509T
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $89.74 | $89.74 | $83.89 - $107.29 | 29 |
| Florida | $78.67 | $78.67 | $75.34 - $81.47 | 3 |
| Georgia | $75.03 | $75.03 | $71.03 - $79.02 | 2 |
| Illinois | $76.31 | $76.31 | $72.62 - $80.16 | 4 |
| Michigan | $74.19 | $74.19 | $72.33 - $76.04 | 2 |
| North Carolina | $73.29 | $73.29 | $73.29 - $73.29 | 1 |
| New York | $86.09 | $86.09 | $74.42 - $91.35 | 5 |
| Ohio | $72.25 | $72.25 | $72.25 - $72.25 | 1 |
| Pennsylvania | $76.68 | $76.68 | $72.53 - $80.82 | 2 |
| Texas | $76.85 | $76.85 | $72 - $81.49 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 0509T
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 0509T 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 |
| 96523 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 99211 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 99211 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 99446 | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 99447 | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 99448 | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 99449 | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 0509T
What does CPT code 0509T mean? +
CPT code 0509T represents: Pattern erg w/i&r. It's in the Category III (Emerging Technology) category with a global period of XXX.
What is the Medicare reimbursement for CPT 0509T? +
The 2026 Medicare national average non-facility payment for CPT 0509T is $80.79. Rates range from $68.46 to $107.29 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 0509T? +
Category III tracking codes generally have no national RVU and carrier-determined payment. Coverage and allowed modifiers are payer-specific; verify before billing.
What bundling edits apply to CPT 0509T? +
This code has 9 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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