CommercialBilling CodesMedium impact
09.00.32al, Reimbursement for Radiopharmaceutical Agents
Independence Blue Cross·Radiology, Nuclear Medicine, Oncology·Claims & Billing
Effective date
Jan 1, 2026
We identified it
Jun 19, 2026
Summary
Independence Blue Cross updated radiopharmaceutical agent policy effective 01/01/2026 with CPT/HCPCS code changes: procedure code C9176 was added and Q9969 was deleted. Billing teams must update systems to reflect these code changes and ensure accurate claim submissions for radiopharmaceutical reimbursement under the revised policy.
Action Required
By 12/31/2025: Billing team must update billing software and fee schedules to reflect CPT/HCPCS code changes effective 01/01/2026. Specifically: (1) Add procedure code C9176 to the radiopharmaceutical agents billing system; (2) Remove procedure code Q9969 from all billing rules and fee schedules; (3) Verify all listed PET scan radiopharmaceutical codes (A9515, A9586, A9587, A9588, A9591, A9592, A9593, A9594) are configured as bundled/non-separately reimbursable; (4) Confirm NOC codes A4641 (diagnostic) and A9699 (therapeutic) are available for agents without specific codes, with provider instructions to report one unit with agent description. Update provider notification materials and billing guidelines. Test billing workflows before 01/01/2026 to prevent claim rejections and denials for improper code usage.