Revamped PET codes take fee schedule limelight

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This article explains a Medicare physician fee schedule update that affects PET coding, along with several additional coding and payment adjustments in other procedure areas. It is useful for coders, billing staff, and reimbursement professionals who need to track CMS updates, understand which code sets are involved, and recognize the broader scope of the changes discussed.

Why This Topic Matters

The update changes how PET services and several other procedures are represented in Medicare billing, making it relevant to organizations that submit claims under the physician fee schedule. Readers can use the article to identify the affected code sets, stay aware of carrier and Medicare policy updates, and assess which specialties or service lines may be impacted.

Article Sections

  1. PET code changes in the Medicare fee schedule update

    Discusses Medicare’s revision of PET-related billing under the physician fee schedule and the shift to CPT-based reporting. It also notes timing and coverage-related aspects of the update.

  2. Additional fee schedule changes affecting other procedures

    Summarizes other coding and payment updates included in the same Medicare release, spanning bilateral indicators, global periods, drug-related codes, and other procedure categories.

What You Will Learn

  • How the Medicare fee schedule update affects PET-related billing
  • Which major code sets are involved in the article
  • What other procedure categories are touched by the same CMS update
  • Which organization issued the underlying guidance
  • How the article frames coverage, component billing, and payment-status changes at a high level

Who Should Read This

  • Medical coders
  • Billing staff
  • Revenue cycle professionals
  • Compliance teams
  • Physician practices
  • Hospital outpatient coding teams

Codes Discussed

Code Ranges Discussed

  • HCPCS LEVEL II: G0030–G0047
  • HCPCS LEVEL II: G0210–G0218
  • HCPCS LEVEL II: G0220–G0234
  • HCPCS LEVEL II: G0253–G0254
  • CPT: 78491–78492
  • CPT: 78608–78609
  • CPT: 78811–78816
  • CPT: 67950–68870
  • CPT: 68840–68899
  • CPT: 91034–91040

Modifiers Discussed


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