CPT 2026 · Category III (Emerging Technology)

CPT 0931T

Global 000

Ephys eval ccm-d ld separate

Effective 2026-04-01 Conv. factor $33.4009

Category III (emerging technology)

Payment Methodology

Status Indicator

NCCI Partners

000

Global Period

Category III (emerging technology)

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 0931T Billing & Documentation Guide

CPT code 0931T (Ephys eval ccm-d ld separate) is classified under Category III (Emerging Technology) with a global period indicator of 000. 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 0931T, 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 0931T with related codes; this code has 10 PTP bundling relationships on file (see table below).

Payment Status & Global Period

CMS Status Indicator

Carrier-priced (MAC determines payment locally)

Global Period

000

Endoscopic or minor procedure with related preoperative and postoperative work performed on the same day

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 0931T 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 0931T

Procedure-to-procedure (PTP) edits. If you bill any of these codes with 0931T on the same date of service, review the modifier indicator and payer policy before submission.

Partner Code	Relationship	Modifier Allowed	Rationale
0915T	Column 1 (primary), can be billed with modifier	No	CPT Manual or CMS manual coding instruction
0916T	Column 1 (primary), can be billed with modifier	No	CPT Manual or CMS manual coding instruction
0917T	Column 1 (primary), can be billed with modifier	No	CPT Manual or CMS manual coding instruction
0918T	Column 1 (primary), can be billed with modifier	No	CPT Manual or CMS manual coding instruction
0919T	Column 1 (primary), can be billed with modifier	No	CPT Manual or CMS manual coding instruction
0920T	Column 1 (primary), can be billed with modifier	No	CPT Manual or CMS manual coding instruction
0921T	Column 1 (primary), can be billed with modifier	No	CPT Manual or CMS manual coding instruction
0922T	Column 1 (primary), can be billed with modifier	No	CPT Manual or CMS manual coding instruction
0923T	Column 1 (primary), can be billed with modifier	No	CPT Manual or CMS manual coding instruction
0924T	Column 1 (primary), can be billed with modifier	No	CPT Manual or CMS manual coding instruction

Frequently Asked Questions, CPT 0931T

What does CPT code 0931T mean? +

CPT code 0931T represents: Ephys eval ccm-d ld separate. It's in the Category III (Emerging Technology) category with a global period of 000.

What is the Medicare reimbursement for CPT 0931T? +

What modifiers can I use with CPT 0931T? +

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 0931T? +

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