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October 7, 2014

Payment for Carrier Priced Codes

CGS has recently had several requests to publish prices for carrier priced codes due to updates for coverage on several Category III CPT codes.  Category III codes are temporary codes for emerging technology, services, and procedures.

Payments for Category III CPT codes are determined on a case-by-case basis, in the same manner in which CGS handles other carrier priced codes.  CGS does not routinely publish payment rates for these codes because many of them require review of medical records for evaluation and pricing.

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