{
    "code": "90868",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/90868/2014/B",
    "release_specific_url": "https://localishealth.com/cpt/90868/2023/C",
    "description": "One treatment session of transcranial magnetic stimulation (TMS), a non-invasive therapy in which a magnetic coil held against the scalp induces electrical activity in a targeted area of the brain. This code covers the routine sessions that follow the initial visit, where the settings and coil position have already been established. The first session in a course is reported differently because it includes mapping the brain target and finding the patient's stimulation threshold; a separate code covers later sessions where that threshold has to be re-measured. A full course typically runs daily over several weeks, so most sessions in a course fall under this code.",
    "answer": {
        "question": "Did Medicare pay separately for CPT 90868 in Q3 2023?",
        "text": "Not at a published national rate. CPT 90868 carries status C (carrier-priced) in the Q3 2023 release. Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation. Treat the blank amount as unpriced, not as $0."
    },
    "release": {
        "schedule": "pfs",
        "year": 2023,
        "quarter": "C",
        "label": "Q3 2023",
        "effective": "July 1 – September 30, 2023",
        "revision": 1
    },
    "status": {
        "code": "C",
        "non_facility_payable": false,
        "facility_payable": false
    },
    "national_rates_usd": {
        "office_non_facility": null,
        "facility": null,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": null,
        "practice_expense_non_facility": null,
        "practice_expense_facility": null,
        "malpractice": null
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 33.8872,
    "source": {
        "label": "Physician relative value file (Q3 2023)",
        "cms_url": "https://www.cms.gov/files/zip/rvu23c.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2023/C",
        "file": "PPRRVU23_JUL.csv",
        "row": 16555,
        "sha256": "64251eae48773025b05c6e45a77e1909e7151c421fe8f346124ba9623c491e37"
    },
    "modified_at": "2026-08-04T03:12:57+00:00"
}