Current Procedural Terminology (CPT)16
Several NeuroStar® CPT codes may be used for reporting the various services related to the delivery of NeuroStar TMS Therapy.
NeuroStar TMS Therapy Category I CPT Codes
Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management
(Report only once per course of treatment)
|90868||Subsequent delivery and management, per session|
|90869||Subsequent motor threshold re-determination with delivery and management (Do not report 90869 in conjunction with 90867, 90868, 95860-95870, 95928, 95929, 95939)|
NeuroStar Code Usage for a Physician:
The AMA created three distinct CPT codes for coding and billing purposes to report TMS Therapy to an insurance carrier.
CPT code 90867 was created to report treatment-planning services during the initial patient visit. This includes determining the patient’s cortical neuron excitability or motor threshold (MT) value, determining and storing the cortical landmark coordinates corresponding to the location where MT was determined, determining and storing the treatment location coordinates, and selecting and storing treatment parameters for a given treatment protocol and the first treatment and delivery session.
CPT code 90868 was created to report services for each session when treatment is delivered and patient management services are provided. For the initial visit (Day 1 of TMS Therapy) when a treatment planning session and a treatment delivery session are completed, 90867 would include both services for the same day. On subsequent treatment days, when only treatment delivery and management is provided, only 90868 would be reported.
CPT code 90869 was created for those individual patient cases when re-determining the motor threshold (MT) is clinically appropriate.
- Bill only one NeuroStar TMS Therapy code for each patient per day
- Sometimes, services other than NeuroStar TMS Therapy are performed on the same date. It may be appropriate for those services to be reported in addition to NeuroStar TMS Therapy
Code Usage for a Hospital: For the Hospital Outpatient Setting, Medicare has assigned CPT Codes 90867 to APC 5722 and 90868 and 90869 to APC 5721.17
Certain guidelines have been outlined for TMS Therapy codes. Please verify these guidelines with the proper coding resources, the individual insurance carrier and the patient’s specific plan.
CPT is a registered trademark of the American Medical Association.
All reimbursement information provided by Neuronetics is for general guidance only. It does not represent a statement, promise, or guarantee by Neuronetics concerning levels of reimbursement, payment, or charge, if any. Coverage and payment for NeuroStar TMS Therapy is based on various factors, including but not limited to, medical necessity, the patient’s specific benefits plan, and individual insurance company’s policies and guidelines. It is the responsibility of the physician and the patient to be knowledgeable of the applicable guidelines.