Nuclear reimbursement resources
We can help you navigate the complex world of reimbursement. The following educational resources provide information regarding coverage and coding of new and existing nuclear medicine procedures.
Billing or purchasing »
NDC »
HCPCS/CPT/Acode »
LYMPHOSEEK®, MPI, MUGA or Xofigo »
Package inserts and FDA-approved radiopharmaceuticals »
Frequently asked questions
Choose a topic below
No, Medicare does not differentiate between SC and FSC. SC and FSC are reported with the same HCPCS code (A9541) and descriptor.
Yes, the $10 add-on payment continues in calendar year 2020. Q9969 can be reported as an ‘add on’ HCPCS code for a Tc-99m dose derived from any non-HEU source
CMS final rule for 2020 allows hospitals to report HCPCS code Q9969 (Tc-99m from non-highly enriched uranium source, full cost recovery add-on per study dose) once per dose along with any diagnostic scan or scan furnished using Tc-99m as long as the TC-99m doses used can be certified by the hospital to be at least 95% derived from non-HEU sources.
Private pay reimbursement information is non-public. Hospitals should consult with their internal billing department or directly with their contracted payers for more information.
Non-nuclear customer?
Find Medical product reimbursement questions on our Medical Affairs site.
Nuclear billing or purchasing questions
For other questions contact your local nuclear pharmacy
Central Billing 866.219.4427
Nuclear-Invoicing-Inquiries@cardinalhealth.com
Location list for purchasing or non-reimbursement nuclear questions
Medicare HOPPS HCPCS/ CPT/ Acode list, description and national payment rate
Final Rule of Medicare Hospital Outpatient Prospective Payment System HOPPS (APC) Medicine Procedures, Radiopharmaceuticals, and Drugs
Medicare physician fee HCPCS/CPT/Acode list, description and national payment rate
Final Rule of Medicare Physician Fee Schedule - Nuclear Medicine Procedures, Radiopharmaceuticals, and Drugs
LYMPHOSEEK® coding, coverage and payment
MUGA coding, coverage and payment
MPI coding, coverage and payment
Xofigo
To purchase Xofigo® in the U.S., please contact XAS (Xofigo® Access Services) at 855.696.3446
Healthcare provider information: https://hcp.xofigo-us.com
Package inserts and material safety data sheets
Current list of FDA-approved radiopharmaceuticals
FDA-approved radiopharmaceuticals and contraindications
Additional nuclear radiopharmaceutical reimbursement questions?
Reimbursement support
- Email: nucmedreimbursement@cardinalhealth.com
- Phone: 866.254.3350
- Hours: 9 a.m. - 6 p.m. EST, Monday - Friday
Disclaimer:
Reimbursement information is provided by Cardinal Health as general coding and payment information and is not legal advice or a substitute for legal or professional counsel. This information is not intended to replace or serve as substitute for your duty to verify that such information is proper for your particular circumstances. Any codes reported should accurately reflect the procedures performed and the patient’s conditions. You may want to consult with local payers to confirm compliance with local policies, or otherwise review and confirm reimbursement policies with your own legal or other professional advisors. The information contained on this website may or may not reflect the most current developments; accordingly, information on this website is not guaranteed to be correct, complete or up to date.Cardinal Health expressly disclaims all liability in respect to actions taken or not taken based on any or all of the contents of this website.
CPT® is a registered trademark of the American Medical Association