October 7, 2014 - Reviewed: 12.19.23
Payment for Carrier Priced Codes
CGS routinely receives requests to publish prices for carrier priced codes due to updates for coverage of Category III CPT codes (i.e., temporary codes assigned to emerging technology, services and procedures).
CGS determines payment for Category III CPT codes in the same manner as other carrier priced codes (i.e., on a case-by-case basis). In addition, we aren’t able to publish these payment rates since many require review of medical records for evaluation and pricing.