travel code cpt

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Specimen Collection and Travel Allowance Fees

Specimen Collection Codes

Specimen Collection Fees

• Only one collection fee per day will be allowed for each patient encounter/trip regardless of the number of specimens drawn
• A specimen collection fee is not allowed when the cost of collecting the specimen is minimal, such as a throat culture or a routine capillary puncture for clotting or bleeding time. This fee will not be paid to anyone who has not extracted the specimen.
• A specimen collection fee is not allowed when the service requiring the collection is not covered due to not being reasonable and necessary or because it is excluded from coverage for other reasons
• Used to perform a clinical lab test paid under the Clinical Lab Fee Schedule; 
• Collected by a trained technician from a Medicare beneficiary who is homebound or is a non-hospital inpatient, but only when no qualified personnel are available at the facility to collect the specimen; and
• Of the following type — a blood specimen collection through venipuncture or a urine sample collected by catheterization
• The phrase “trained technician” refers to those staff providing specimen collection services. It does not mandate certain educational requirements and, for the purposes of the specimen collection provisions, the term includes a phlebotomist.
• Drawing a blood sample through venipuncture (i.e., inserting into a vein a needle with syringe or vacutainer to draw the specimen); or
• Collecting a urine sample by catheterization 

Independent Laboratory

• The trained technician must personally draw the specimen (e.g., venipuncture or urine sample by catheterization)
• Medicare does not allow a specimen collection fee to the visiting technician if a patient in a facility is not confined to the facility or the facility has personnel on duty qualified to perform the specimen collection
• A patient need not be bedridden to be homebound
• When a laboratory obtains the specimen collection in the home place of service (POS 12 or 14) or nursing facility (POS 13, 31, 32, 33 or 54) it may receive payment for both the draw and for the associated travel to obtain the specimen(s) for testing
• When an independent laboratory obtains a specimen for a nursing home patient, a non-hospital inpatient, or homebound patient, the homebound indicator must appear in Loop 2300, CRC/75, 03 for electronic claims. For paper claims, the statement "homebound" must appear in Item 19 of the CMS-1500 claim form. Claims submitted without this information will be rejected as unprocessable (remark code MA130).
• A patient will be considered to be homebound if he or she has a condition due to an illness or injury that restricts his or her ability to leave the residence except with the aid of supportive devices (such as crutches, canes, wheelchairs and walkers); the use of special transportation; the assistance of another person; or if leaving home is medically contraindicated. (See Publication 100-02, the Medicare Benefit Policy Manual Chapters 7 and 15 , for more information regarding medically necessary laboratory services to a homebound or institutional patient.) 

Travel Allowance

• Travel allowance may be made in addition to a paid, medically necessary specimen collection fee when the specimen is collected from a nursing home patient, a nonhospital inpatient or homebound patient
• 12 — home
• 13 — assisted living facility
• 14 — group home
• 31 — nursing facility
• 32 — domiciliary care
• 33 — custodial care
• 54 — intermediate care facility
• Claims for travel allowance submitted with place of service 81/independent lab will be denied
• The travel allowance will not be paid if a trained technician merely performs a messenger service to pick up a specimen drawn by other technicians
• The allowance is intended to cover the transportation and personnel expenses for trained personnel to travel to the location of an individual to collect the sample 
• Eligible miles by a trained technician’s travel for specimen collection from Medicare beneficiaries may begin at a laboratory or at a location other than the laboratory. Therefore, eligible miles begin at the laboratory or the starting point of the trained technician’s travel for specimen collection. 
• Additionally, a trained technician’s travel for specimen collection from Medicare beneficiaries may end at a laboratory or at a location other than the laboratory. Therefore, eligible miles end at the laboratory or the ending point of the trained technician’s travel for specimen collection. 
• Eligible miles do not include miles traveled for any purpose unrelated to specimen collection, such as collecting specimens from non-Medicare beneficiaries or for personal reasons. Therefore, any miles traveled to a location where no specimens are collected, such as to the location of a non-Medicare beneficiary for specimen collection, to a Medicare beneficiary where no specimen collection occurs, or for personal purposes, are excluded from the calculation of eligible miles. 
• CMS has made permanent the option for laboratories to maintain electronic documentation of miles traveled for the purposes of covering the transportation and personnel expenses for trained technicians to travel to the location of an individual to collect a specimen sample. This option for laboratories to maintain electronic documentation applies to specimen collection for any clinical laboratory test. Laboratories may use electronic and/or other documentation in order to demonstrate miles traveled for the purposes of specimen collection. Laboratories need to be able to produce electronic documentation in a form and manner that can be shared with MACs and should continue to consult with their local MACs regarding the format and process for submission of this information if necessary. 

HCPCS Code P9603 — When/How to Use This Code

• The round trip travel to one location is greater than 20 eligible miles for specimen collection from one or more beneficiaries; or
• When travel is to more than one location, regardless of the number of miles traveled
• Use HCPCS code P9603 to receive payment for the per mile travel allowance amount, prorated by the number of beneficiaries for whom a specimen collection fee is paid
• See Publication 100-04, Chapter 16, Section 60.2  (PDF)for the per-mile travel allowance calculation
• The quantity billed for HCPCS code P9603 must reflect the actual number of miles traveled

HCPCS Code P9604 — When/How to Use This Code

• The flat rate travel allowance basis applies when the trained technician travels 20 eligible miles or less to and from one location for specimen collection from one or more Medicare beneficiaries
• Use HCPCS code P9604 to receive payment for the flat rate travel allowance amount, prorated by the number of beneficiaries for whom a specimen collection fee is paid 
• The quantity billed must be one
• See Publication 100-04, Chapter 16, Section 60.2 (PDF) for the flat rate travel allowance calculation

HCPCS Modifier LR

• Laboratories should submit HCPCS modifier LR (informational purposes only) to indicate "Round Trip" on HCPCS code P9604
• CMS Publication 100-02, Chapters 7, 15, and 16, Section 180
• CMS Publication 100-04, Chapter 16, Section 50.5 (PDF)
• CMS Publication 100-04, Chapter 16, Section 60  (PDF)

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Fam Pract Manag. 2021;28(3):34

Author disclosure: no relevant financial affiliations disclosed.

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April 15, 2024

Can I Get Paid for…Travel Counseling

So your patient is going to the Galapagos, and wants your advice. Can you get paid for travel counseling? This short video has the answer.

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You Code It! Answers: Travel Counseling

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American Academy of Pediatrics; You Code It! Answers: Travel Counseling. AAP Pediatric Coding Newsletter February 2020; 15 (5): 10–11. 10.1542/pcco_book190_document005

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The 2 coding scenarios presented each included travel counseling in addition to other services. However, as shown for the first scenario, these services are not always separately reported.

A 13-year-old established patient presents for a routine health examination during which her parents request advice on health safety during an upcoming monthlong stay overseas. The pediatrician spends approximately 10 minutes discussing potential health concerns, including recommended prophylactic immunization, medical evacuation insurance, and referral to a travel clinic that can provide a recommended immunization not available in the pediatrician’s practice. Diagnoses are routine health examination and pretravel counseling.

Per Current Procedural Terminology ( CPT ® ), preventive medicine counseling codes are not separately reportable in conjunction with preventive medicine evaluation and management (E/M) services (here, 99394 ). The travel counseling in this encounter would not be separately reported. Had the patient presented with a problem that required management (eg, type 1 diabetes) in preparation for travel, a significant, separately identifiable office E/M service (eg, 99213 ) would be reported with modifier 25 appended.

The primary diagnosis code for this encounter is Z00.129 (encounter for routine child health examination without abnormal findings). Code Z71.84 (encounter for health counseling related to travel) is reported as a secondary code.

Example Coding

The second coding scenario supports separate reporting of travel counseling.

A 45-month-old girl presents with an injury to her left foot from stepping on a roofing staple in her backyard. The child’s parents note concerns that they will travel overseas to visit family in 6 weeks. They ask questions about health concerns and receiving health care during their visit.

A pediatrician evaluates and bandages the small puncture wounds and recommends early administration of diphtheria, tetanus, and acellular pertussis (DTaP) vaccine and other immunizations that would otherwise be given when the patient is 4 years old. The pediatrician documents 15 minutes spent reviewing concerns for the areas the family will visit and providing recommendations. Routine immunizations are provided with the pediatrician counseling for DTaP, poliovirus (IPV), and measles, mumps, rubella, and varicella (MMRV) vaccines. A referral to a travel clinic is provided for other immunizations not available in the pediatric practice.

The pediatrician’s total face-to-face time of the visit is 25 minutes. Diagnoses are puncture wound left foot, routine immunization, and counseling for travel.

The pediatrician provided 3 distinct services: an office E/M visit to evaluate and treat the child’s injury, preventive medicine counseling about upcoming travel, and administration with physician counseling for each immunization administered at the encounter. Coding for the E/M visit is based on the 3 key components (ie, history, physical examination, medical decision-making), not time. The total face-to-face time was, in part, spent providing the separately reported travel and immunization counseling. Modifier 25 is required to be appended to the E/M visit code to indicate a significant, separately identifiable E/M service addressing the injury was provided on the same date as the immunization administration and preventive medicine counseling. Assume combination vaccines were administered for DTaP-IPV and MMRV. Codes are assigned for each vaccine product and for the administration services for each initial and subsequent component of the 2 vaccine products. The time of travel counseling was 15 minutes. Code 99401 is reported with modifier 25 appended to indicate separate counseling from that associated with immunization administration.

Abbreviations: E/M, evaluation and management; IM, intramuscular.

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Infectious Diseases

Important information for travel visits.

• This appointment will consist of a travel consultation and possible immunizations. The final decision to administer vaccinations lies with the physician after careful review of the situation.
• Before you arrive, please fill out the Travel Clinic Questionnaire. Once you schedule an appointment, the questionnaire can be found in your MyChart account , our secure online patient portal. If you don’t yet have a MyChart account through UConn Health, enrollment only takes a few minutes and will allow you to access all your patient information in one place. If you cannot create a MyChart account, you can complete a fillable questionnaire , print it, and bring it to your appointment.
• Minors must have a parent present at the appointment.
• Visits typically last at least one hour. Thirty minutes with the provider and then an additional 15 to 30 minutes with the nurse.
• It is important to have details of your itinerary so the doctor can make a thorough assessment of the health risks.
• Bring prior immunization records with you (even if you have been seen at UConn Health before) to this appointment, including prior travel-related vaccination records (yellow card) as well as pediatric immunization records for any children who are being seen. If you do not bring these immunization records, you or your child may not be seen.
• The travel consultation with the doctor will be billed as Preventive Counseling. It cannot be billed as an office visit.
• The Preventive Counseling fee for each person will average $145.00. The cost may be higher (up to $260.00) depending on complexity of travel consultation.
• The CPT codes used for Preventive Counseling are 99401, 99402, 99403, 99404, 99411 or 99412. One code will be billed depending on how detailed your visit is and how many people are involved in the visit (i.e., two or more people traveling together). You should check for coverage of each of these codes with your insurance company prior to your visit.
• You will be charged an immunization fee for each immunization given.
• Cost of immunizations vary greatly but typically range from $50.00 to $160.00 per shot.
• In general, your visit will cost between $200.00 and $500.00.
• You will be billed for any services your insurance does not cover.
• If your insurance requires you to obtain a referral from your primary care physician be sure to follow-through; if a required referral is not obtained you cannot be seen.

Journal of Urgent Care Medicine

Practice Management

Travel Immunizations

Q . what is the best way to code for and bill patients who come in because they are planning to travel out of the country and need to know what immunizations they should have before traveling we advise them on preventive measures to take in relation to where they are traveling, provide literature if appropriate, and even try to find health-care facilities close to where they will be staying while abroad. i know we can bill for any vaccines that are administered, but can we also bill an evaluation and management (e/m) code.

A. You are correct that you can bill for any immunization(s) provided, as well as for the administration of the immunization(s). Bill the appropriate code in the medicine section of the Current Procedural Terminology (CPT) manual. For example, you verified that all routine immunizations are up-to-date except for tetanus, and on the basis of the destination of the patient, you discuss preventive measures to take regarding what foods and activities to avoid, how to self-treat minor ailments (such as diarrhea), provide information on medical facilities in the area and guidance on safe contact with animals indigenous to the area. You determine that the patient should receive the tetanus, yellow fever, typhoid, and polio vaccines. You would bill procedures as follows:

• 90715 : “Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap), when administered to individuals 7 years and older, for intramuscular use”
• 90717 : “Yellow fever vaccine, live, for subcutaneous use”
• 90690 : “Typhoid vaccine, live, oral”
• 90713 : “Poliovirus vaccine, inactivated (IPV), for subcutaneous or intramuscular use”
• 90460 : “Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional;first or only component of each vaccine or toxoid administered”
• 90461 : “Each additional vaccine or toxoid component administered (list separately in addition to code for primary procedure)”

You will notice that the codes for the immunization administration include a counseling component. However, if you are researching information regarding the travel destination of the patient, offering guidance on which immunizations are needed and guidance on how to avoid sickness and injury while traveling, that is more counseling than is required for just administering those immunizations.

According to CPT guidelines, if you are seeing a patient for a visit and more than 50% of the time spent in the visit is attributed to counseling, you may select the visit level on the basis of the typical time shown for each level of visit:

• • 99201: 10 minutes
• • 99202: 20 minutes
• • 99203: 30 minutes
• • 99204: 45 minutes
• • 99205: 60 minutes
• • 99211: 5 minutes
• • 99212: 10 minutes
• • 99213: 15 minutes
• • 99214: 25 minutes
• • 99215: 40 minutes

If the patient comes to the clinic only for counseling regarding immunizations required for foreign travel and preventive travel measures, then you might consider codes from the preventive medicine section of CPT:

• 99401: “Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 15 minutes”
• 99402: “Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 30 minutes”
• 99403: “Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 45 minutes”
• 99404: “Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 60 minutes”

As always, when the code you choose is based on time, that time spent must be documented, as well as what topics were discussed and the advice you gave. Please note that some payors deny these services as uncovered services. This is especially true for payors with urgent care contracts that specifically exclude preventative or primary-care services

The diagnosis code(s) to use will be determined by the services performed in the clinic. If the patient received immunizations, you would use ICD-10 [International Classification of Diseases, 10th revision, Clinical Modification] code Z23, “encounter for immunization,” no matter how many immunizations were administered. This is one area where ICD-10 decreased the number of codes used to report the reason for the encounter. It was decided that one diagnosis code would be used to represent any immunization, as opposed to ICD-9 [International Classification of Diseases, Ninth Revision, Clinical Modification], where there were diagnosis codes that specified many different types of immunization, (i.e., V04.61, “need for prophylactic vaccination and inoculation against tetanus pertussis combined vaccine,” or V04.4, “need for prophylactic vaccination and inoculation against yellow fever,” etc.). If only counseling was provided and no vaccines were administered, you would just code Z71.89, “other specified counseling.”

Be sure to check with payors regarding their policies for any of these services. DAVID STERN, MD ( Practice Velocity )

David Stern, MD

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List of CPT/HCPCS Codes

We maintain and annually update a List of Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS) Codes (the Code List), which identifies all the items and services included within certain designated health services (DHS) categories or that may qualify for certain exceptions. We update the Code List to conform to the most recent publications of CPT and HCPCS codes and to account for changes in Medicare coverage and payment policies. Code List updates for years 2022 and earlier were published in the Federal Register as an addendum to the annual Physician Fee Schedule final rule. 

Beginning with the Code List effective January 1, 2023, updates are published solely on this webpage.  On or before December 2 nd of each year, we will publish the annual update to the Code List and provide a 30-day public comment period using www.regulations.gov . To be considered, comments must be received within the stated 30-day timeframe. We anticipate that most comments will be addressed by April 1 st ; however, a longer timeframe may be necessary to address complex comments or those that require coordination with external parties. If no comments are received, in lieu of a comment response, we will publish a note below the applicable Code List year stating so. 

2024 Annual Update to the Code List

Below you will find the Calendar Year (CY) 2024 Code List published November 29, 2023 and a description of the revisions for CY 2024, our response to comments on that Code List, and the updated CY 2024 Code List, which is effective January 1, 2024 unless otherwise indicated on the Code List.

• UPDATED list of codes effective January 1, 2024, published March 1, 2024 (all codes effective January 1, 2024 unless otherwise indicated on the Code List) (ZIP)
• List of codes effective January 1, 2024, published November 29, 2023 (ZIP)
• Annual Update to the List of CPT/HCPCS Codes Effective January 1, 2024 (PDF)

We received one comment related to the additions, deletions, and corrections to the codes on the Code List effective January 1, 2024. Our response to this comment is below. We also received one comment related to Medicare coverage for platelet-rich plasma treatments. We consider this comment to be outside the scope of the annual update. CMS does not respond to out of scope comments on the annual updates to the Code List. 

Comment : One commenter noted that, although most Hepatitis B vaccine codes are identified on the Code List as CPT/HCPCS codes to which the exception for preventive screening tests and vaccines at § 411.355(h) applies, the Hepatitis B vaccine associated with CPT code 90739 was not listed. The commenter requested that CPT code 90739 be added to the list of vaccine codes to which the exception for preventive screening tests and vaccines at §411.355(h) applies, effective retroactively to January 1, 2024.

Response : We agree with the commenter that the exception for preventive screening tests and vaccines at § 411.355(h) should apply to CPT code 90739 and are revising the Code List accordingly. The applicability of the exception for preventive screening tests and vaccines to CPT code 90739 is prospective only and effective on the date indicated on the UPDATED list of codes. 

In considering this comment, we also identified two CPT codes (90653 and 90658, both flu vaccines) that were inadvertently left off of the list of codes to which the exception for preventive screening tests and vaccines at § 411.355(h) should apply. Accordingly, we are adding these CPT codes to the list of codes to which the exception at § 411.355(h) applies, effective on the date indicated on the UPDATED list of codes.

2023 Annual Update to the Code List

Below you will find the Code List that is effective January 1, 2023 and a description of the revisions effective for Calendar Year 2023. 

• List of codes effective January 1, 2023, published December 1, 2022
• Annual Update to the List of CPT/HCPCS Codes Effective January 1, 2023, published December 1, 2022 (PDF)

The comment period ended December 30, 2022. We did not receive any comments related to the additions, deletions, and corrections to the codes on the Code List effective January 1, 2023. We received one (1) comment related to the supervision level required for specific services. We consider this comment to be outside the scope of the annual update. CMS does not respond to out of scope comments on the annual updates to the Code List. 

DHS Categories

The DHS categories defined by the Code List are:

• clinical laboratory services;
• physical therapy services, occupational therapy services, outpatient speech-language pathology services;
• radiology and certain other imaging services; and
• radiation therapy services and supplies.

The Code List also identifies those items and services that may qualify for either of the following two exceptions to the physician self-referral prohibitions: 

• EPO and other dialysis-related drugs (42 CFR § 411.355(g)).
• Preventive screening tests and vaccines (42 CFR § 411.355(h)).

NOTE: The following DHS categories are defined at 42 CFR §411.351 without reference to the Code List:

• durable medical equipment and supplies;
• parenteral and enteral nutrients, equipment and supplies;
• prosthetics, orthotics, and prosthetic devices and supplies;
• home health services;
• outpatient prescription drugs; and
• inpatient and outpatient hospital services.

Related Links

• List of codes effective January 1, 2022, published November 19, 2021
• List of codes effective January 1, 2021, issued December 1, 2020
• List of codes effective January 1, 2020, published December 2, 2019
• List of codes effective January 1, 2019, published November 23, 2018
• List of codes effective January 1, 2018, published November 3, 2017 [ZIP, 59KB]
• List of codes effective January 1, 2017, published November 16, 2016 [ZIP, 54KB]
• List of codes effective January 1, 2016, published October 30, 2015 [ZIP, 58KB]
• List of codes effective January 1, 2015, published November 13, 2014 (79 FR 67972) [ZIP, 54KB]
• List of codes effective January 1, 2014, published December 10, 2013 (78 FR 74791) [ZIP, 54KB]
• List of codes effective January 1, 2013, published November 16, 2012 (77 FR 69334) [ZIP, 54KB]

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BetMGM Bonus Code NYPNEWS: Grab $1.5K first bet or 20% deposit match; $150 bonus in NC

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Nba sunday schedule.

Playoff seeds are still yet to be decided as we enter the final day of the 2023-24 NBA regular season. ESPN is showing two games: Bulls vs. Knicks at 1 p.m. ET and Lakers-Pelicans at 3:30 p.m. ET.

Below is a list of all 15 games on the NBA regular season finale.

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