Physicians and other qualified health care professionals who provide chimeric antigen receptor T-cell (CAR-T) therapy services (eg, pediatric oncologists) now have codes for reporting these services. Current Procedural Terminology (CPT®) Category III codes 0537T–0540T were released to the American Medical Association website on July 1, 2018, and implemented on January 1, 2019.

CPT Category III codes are assigned to services that represent new or emerging technology, services, procedures, and service paradigms. These codes are used for tracking utilization until the services represented by the codes have been determined to be consistent with current medical practice and are performed by many physicians/practitioners in clinical practice in multiple locations. Individual payers may or may not develop coverage policies for services represented by Category III codes. It is necessary to verify benefits with each individual health plan to determine cover-age and payment values prior to providing these services.

As indicated...

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