MA09.009y, Reimbursement for Radiopharmaceutical Agents

By March 15, 2025: Billing team must obtain the complete policy text from the URL provided and identify all specific radiopharmaceutical CPT/HCPCS codes affected. Update billing system edits, fee schedules, and claim submission logic to reflect new reimbursement rules. Communicate any coding or documentation changes to providers and clinical staff. Test updated billing workflows before the April 1, 2025 effective date. NOTE: The policy content summary provided does not include specific affected codes—the full policy text must be reviewed to identify exact CPT codes (e.g., 78xxx series for nuclear medicine) and HCPCS J-codes for radiopharmaceuticals that are subject to the new reimbursement methodology.