CPT code

ReimbursementCodes.com is an online HCPCS Reimbursement code pricing database providing the most up to date, accurate reimbursement information for any CPT code that may be administered in a provider's office, clinic or home health agency using current CMS (formerly HCFA) guidelines.

What is a Reimbursement Code?

Reimbursement codes are a component of the CMS (formerly HCFA) Common Procedure Coding System (HCPCS) and Current Procedural Terminology (CPT) for Vaccines, Immune Globulins and Toxoids. Reimbursement codes are designed to bill for drugs that are administered in the provider's office, clinic or home health agency either injected sub-cutaneously, intramuscularly, or intravenously as well selected orally administered chemotherapeutic agents. The reimbursement code only covers the cost of the medication using CMS (formerly HCFA) guidelines. Office charges associated with the administration of the medication are billed separately.

What is a Vaccine/Immune Globulin/Toxoid Code?

CPT code (Current Procedural Terminology)

CPT codes for Immune Globulins, Vaccines & Toxoids. Immune globulin products listed include broad-spectrum and anti-infective immune globulins, antitoxins, and various isoantibodies. Vaccines/Toxoids: multiple codes for a particular vaccine/toxoid are provided in CPT when the schedule (number of doses or timing) differs for two or more products of the same vaccine type (e.g. hepatitis A, HiB) or the vaccine product is available in more than one chemical formulation, dosage, or route of administration. A separate CPT code is available for combination vaccines (e.g. DTP-Hib, DtaP-Hib, HepB-Hib). It is inappropriate to code each component of a combination vaccine separately. If a specific vaccine code is not available, the unlisted procedure code should be reported, until new CPT code becomes available.

The timely, accurate reference provided by ReimbursementCodes.com allows MCOs, Insurance Companies and providers to accurately price medications administered in the providers office, clinic or home health agency, resulting in:

More rapid claims processing.
Faster reimbursement for services rendered.
Fewer rejected claims.
Fewer calls to provider relations.
Improved provider relations.
More accurate revenue forecasts.

The ReimbursementCodes.Com database is a component of the R. J. Health Systems' Reimbursement Code Pricing Guide, a comprehensive, accurate, single source reference for the current pricing of the CMS (formerly HCFA) established HCPCS and Current Procedural Terminology Codes - CPT code - for medications administered in the provider's office, clinic or home health agency.

ReimbursementCodes.com Database features:

Listing of all established J, Q, C, S, K, and CPT codes with corresponding descriptions as established by CMS (formerly HCFA) and AMA.

AWP Pricing - criteria specified by CMS (formerly HCFA).
AWP*-5%, in billable units corresponding to each Reimbursement Code description.
Ability to query by:
- Reimbursement Code (HCPCS or CPT codes)
- Drug name (brand or generic)
- NDC Code

Examples on how to bill using a CMS (formerly HCFA) 1500 form when:

There is no established reimbursement code for the drug.
There is an established reimbursement code for the drug.
The provider does not supply the drug.

CPT code database updated monthly
The Reimbursement-Codes.com database is updated monthly. Prices for Reimbursement Codes and CPT code information are updated at the close of business on the last day of the month reflecting price changes through the 15th of the month.

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