Cardiac Positron Emission Tomography Pricing Change

Effective 1/1/2020 there nine CPT codes that describe PET as noted in the lists below. Of the nine listed codes, six (group 1) are new for 2020 and are contractor priced codes for the TC and global service for Medicare Part B.

Group 2 contains those procedures that were in effect prior to 1/1/2020.

After reviewing the services described by the codes; and current and past pricing methodology, the services as noted below will have an equitable reimbursement adjustment for the TC and the global service for the procedures reported under Medicare Part B.

The timing of these adjustments are noted below and are based on DOS.

Group 1:

Part B pricing adjustments will be effective for services rendered on or after 4/1/2021 for these CPT codes that became effective January 2020:

• • 78429
  • 78430
  • 78431
  • 78432
  • 78433
  • 78434

Group 2:

Part B pricing adjustments will be effective for services rendered on or after 8/1/2021 for these CPT codes that were effective prior to 2020:

• • 78459
  • 78491
  • 78492 

The updated fee schedules will be available on our website after July 1 for Group 1 and after August 1 for Group 2 at physician fee schedules.

Posted 6/16/2021