Summary & Overview
CPT 0395T: Interstitial or Intracavitary High-Energy Brachytherapy with Dosimetry
Headline: New CPT code 0395T defined for interstitial and intracavitary high-energy brachytherapy with dosimetry
Lead: CPT code 0395T represents placement of a catheter into tumor tissue or a body cavity to deliver a high-energy radioactive source, including dosimetry when performed, and is reported per fraction of the planned treatment.
CPT code 0395T defines a brachytherapy service that combines catheter placement with loading of a high-energy radioactive substance and includes dose calculation when performed. This procedure supports targeted radiation delivery for malignant tumors and is relevant for radiation oncology providers, hospital billing teams, and payers managing oncology services. Nationally, precise coding for brachytherapy is important for aligning payment with resource use and ensuring consistent documentation of fractionated treatments.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context and service settings, common billing and coding considerations, and expected areas where payers may apply coverage rules or require documentation. The publication summarizes benchmarks and policy updates relevant to brachytherapy billing, clarifies the unit-of-service reporting (per fraction or portion of planned dose), and outlines implications for hospital and ambulatory surgical center claims.
This resource is intended to help coding professionals, revenue cycle teams, and policy analysts understand the clinical service represented by CPT code 0395T and what elements drive documentation and payer review.
Billing Code Overview
CPT code 0395T describes placement of a catheter either within cancerous tissue (interstitial) or within a body cavity (intracavitary) that is loaded with a high-energy radioactive substance to treat tumors. The procedure includes preloading dosimetry (dose calculation) of the radioactive substance when performed and is reported for each fraction or portion of the planned total dose delivered.
Service type: Procedural radiation therapy (brachytherapy), interstitial or intracavitary placement with dosimetry
Typical site of service: Hospital inpatient or outpatient procedural areas, ambulatory surgical centers, and specialized radiation oncology suites
Clinical & Coding Specifications
Clinical Context
A 64-year-old patient with a recently diagnosed localized cervical carcinoma is scheduled for intracavitary high-dose-rate (HDR) brachytherapy following external beam radiation therapy. The patient arrives to the radiation oncology suite in a monitored setting. Under conscious sedation or general anesthesia, the radiation oncologist inserts a gynecologic applicator and places interstitial catheters into tumor tissue as indicated. Dosimetry calculations (treatment planning) are performed prior to loading the radioactive source into the catheters. Each treatment fraction is delivered with source loading and dwell-time control; this service is reported per fraction using 0395T. The clinical workflow includes pre-procedure consent and imaging, applicator/catheter placement, treatment planning/dosimetry, source loading and delivery, and post-treatment monitoring and documentation. Typical sites of service are an outpatient radiation oncology department, ambulatory surgery center, or hospital-based procedure room depending on anesthesia needs and patient acuity.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When reporting the physician component separate from technical services if the facility bills technical work. |