What is the CPT code for platelet-rich plasma injection?

0232T
For all other uses of PRP, the CPT code 0232T should be billed. It describes the injection of PRP into a targeted site.

Is CPT code 0232T covered by Medicare?

The Center for Medicare and Medicaid Services (CMS) NCD 270.3 outlines the coverage of PRP for the treatment of chronic non-healing diabetic, venous/ and or pressure wounds. For all other uses of PRP, the CPT code 0232T should be billed.

Does Medicare pay for platelet-rich plasma injections?

Quick Answer: Platelet-Rich Plasma Injection is not covered under Medicare.

What is the CPT code for prolotherapy?

There is no CPT code designated for prolotherapy. To the extent that prolotherapy involves the injection of a ligament or tendon, you may be able to submit 20550, “Injection; tendon sheath, ligament, ganglion cyst,” for this service.

What is the CPT code 20610?

Group 1

Code Description
20610 ARTHROCENTESIS, ASPIRATION AND/OR INJECTION, MAJOR JOINT OR BURSA (EG, SHOULDER, HIP, KNEE, SUBACROMIAL BURSA); WITHOUT ULTRASOUND GUIDANCE

Why does insurance not cover PRP injections?

Oftentimes, PRP is not covered by insurance because many health insurance companies recognize PRP as an experimental treatment.

Is platelet rich plasma therapy covered by insurance?

PRP injections are currently deemed “investigational/experimental” by insurance plans and therefore are not covered.

What is CPT code M0076?

Medical services. M0076 is a valid 2021 HCPCS code for Prolotherapy used in Medical care.

What is CPT code H0031?

H0031 per hour MENTAL HEALTH ASSESSMENT – Used for initial evaluation/assessment, initial functional analysis and periodic functional analysis re-assessments (must be done by a licensed provider or BCBA).

What is the CPT code 20600?

20600: Arthrocentesis, aspiration and /or injection, small joint or bursa (eg, fingers; toes); without ultrasound guidance, with permanent recording and reporting.

Can CPT code 20610 be billed with 99213?

Per CCI edits, CPT codes 20610-RT and 99213-25 cannot be billed together; however a modifier is allowed with supporting documentation.