December 31, 2015

CT Modifier Issued for non-NEMA Standard XR-29-2013-Compliant Equipment

The Centers for Medicare and Medicaid Services (CMS) issued MLN Matters article MM9250 on November 6 to provide background and guidance on the use of the new “CT” modifier for providers submitting claims for Computed Tomography (CT) Services.

As reported in the September/October 2015 ACR Radiology Coding Source™, effective for claims on or after January 1, 2016, CMS is requiring the use of the modifier “CT” for applicable CT scans furnished on non-NEMA Standard XR-29-2013-compliant equipment. The use of this modifier will result in a payment reduction for the technical component (and the technical component of the global fee) of 5 percent in 2016 and 15 percent for 2017 and subsequent years for CPT codes 70450-70498; 71250-71275; 72125-72133; 72191-72194; 73200-73206; 73700-73706; 74150-74178; 74261-74263; 75571-75574 and successor codes. The statutory provision requires that verification of compliance be provided and attested to by both a supplier and a hospital outpatient department and that such information shall be verified, as appropriate, as part of periodic accreditation.

Further information regarding the NEMA Standard XR-29-2013 can be found in the XR-29 FAQs issued by the ACR Quality and Safety department.

Please contact Dominick Parris in the Department of Economics and Health Policy with your questions at