Intensive Behavioral Assessment for Destructive Behavior
CPT 0362T
Reported when assessing a patient with severe destructive or self-injurious behavior requires two or more technicians and a specially controlled setting.
No national payment amount
Carrier-priced: no national payment amount.
Does Medicare pay separately for CPT 0362T in 2026?
Not at a published national rate. CPT 0362T carries status C (carrier-priced) in the Q3 2026 release. Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation. Treat the blank amount as unpriced, not as $0.
Common questions
Why is there no payment amount for 0362T?
Its status indicator is C (carrier-priced). Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation. The blank is deliberate: the amount is either unknown or paid under another provision, so reading it as $0 would be wrong.
Why would a Medicare claim for 0362T be denied or paid less?
Each item below comes from a CMS indicator on this page — not general billing advice.
- Its status indicator is C (carrier-priced) — Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation. See status indicators
- 70 codes can never be billed with 0362T on the same date of service — NCCI denies those pairs even with a modifier. See billing together
- 174 codes pair with 0362T only when modifier 59 (or XE, XS, XP, XU) documents a distinct service — billed together without one, a line of the pair denies. See billing together
Payer-specific coverage and documentation rules live outside these files, so a claim that clears every check here can still be denied on other grounds.
When does this rate change?
CMS publishes a fee schedule release every quarter (January, April, July, October), and each is versioned here. See what changed each release, or get an email when a new release moves rates.
Sources: CMS Medicare Physician Fee Schedule Relative Value Files.
Saw this code on your bill?
What is a 0362T visit in patient-friendly terms?
In plain terms: A structured behavioral assessment for a patient - most often a child with autism spectrum disorder - whose behavior is destructive or unsafe enough that it takes two or more trained technicians working together, in a specially arranged setting, to complete the evaluation safely. A supervising physician or behavioral specialist is on site directing the assessment, which is billed in 15-minute increments of technician time. It is the higher-intensity counterpart to the standard single-technician assessment code, reserved for cases where safety concerns require extra staff. Think of a child with autism whose self-injurious behavior is severe enough that a single technician cannot safely conduct a standard behavioral assessment. Two technicians work together in a padded, controlled room while a supervising clinician oversees the session, systematically identifying what triggers and reduces the behavior. You'll typically see CPT 0362T on a bill or explanation of benefits (EOB) when a clinician performs or bills for this service.
How this amount is computed
amount = (work RVU × work GPCI + PE RVU × PE GPCI + MP RVU × MP GPCI) × conversion factor. National amounts use GPCI = 1.000. To price an RVU figure of your own, use the RVU-to-dollars converter.
| Component | RVU |
|---|---|
| Work RVU | blank |
| Practice expense RVU (non-facility) | blank |
| Practice expense RVU (facility) | blank |
| Malpractice RVU | blank |
Every rate combines three parts: work (the clinician’s time, skill and effort), practice expense (office overhead — higher when the service is done in a doctor’s own office), and malpractice (the share of liability-insurance cost). A blank means CMS publishes no national number for that part. Read it as unknown, and never as zero.
Rate history by release
National non-facility amount for 0362T across quarterly releases.
| Release | Status | Non-facility | Facility |
|---|---|---|---|
| Q3 2026 Jun 30, 2026 – present | C | — | — |
| Q2 2026 Mar 10, 2026 – Jun 29, 2026 | C | — | — |
| Q1 2026 Dec 29, 2025 – Mar 9, 2026 | C | — | — |
| Q4 2025 Sep 11, 2025 – Dec 28, 2025 | C | — | — |
| Q3 2025 Jun 5, 2025 – Sep 10, 2025 | C | — | — |
| Q2 2025 Jun 5, 2025 – Jun 4, 2025 | C | — | — |
| Q1 2025 Dec 23, 2024 – Jun 4, 2025 | C | — | — |
Billing together (NCCI edits)
NCCI Q3 2026Based on CMS's National Correct Coding Initiative (NCCI) — hover a code to see how it's used.
Never billable with 0362T on the same date of service
Showing 3 of 70 — search above to check a specific code.
No match in this list.
Billable with 0362T only with modifier 59, XE, XS, XP, or XU
Showing 3 of 174 — search above to check a specific code.
No match in this list.
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Source & method
This is computed from CMS's Medicare Physician Fee Schedule Q3 2026 release (schedule pfs, effective July 2026). National amounts apply a GPCI of 1.000 and leave sequestration off. The status indicator decides payability, never the RVU values, so a blank RVU stays blank. Releases are immutable: a rate retrieved for a past quarter always reflects that release. Commercial and cash-pay figures anywhere on this page are arithmetic on the Medicare amount, using commonly cited reimbursement ranges. They're illustrative, and no nationwide claims database stands behind them.
Description written from primary sources: CMS Medicare Physician Fee Schedule Relative Value Files. Not derived from AMA CPT descriptor text.
Conversion factor $33.4009 read from the same file, row 11, column 26.
Use the (i) buttons next to each amount above for the exact row, columns, and math.
Cite this rate
This link keeps pointing at the Q3 2026 figures, even after a newer release lands.
CPT 0362T Medicare Physician Fee Schedule rate (Q3 2026). Localis. https://localishealth.com/cpt/0362T/2026/C