Summary & Overview
CPT 38226: T-Cell Preparation for CAR–T Therapy
CPT code 38226 documents the provider’s preparation of a patient’s T lymphocytes for transport to a laboratory as part of CAR–T cell therapy workflows. This service captures a distinct, clinically necessary handling step between apheresis collection and laboratory modification or testing of cellular products. Nationally, accurate use of this code supports tracking of complex cell-therapy supply chains, appropriate claims processing, and visibility into the growing volume of autologous cellular therapies.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of how the code fits into CAR–T service lines, typical sites of service where the procedure occurs, and common billing considerations. The publication also summarizes available payer coverage patterns, reimbursement benchmarks where available, and relevant policy updates that affect claims adjudication and documentation requirements.
This guidance aims to clarify the clinical and billing context for CPT code 38226, improving transparency around cellular therapy specimen handling and helping stakeholders align documentation and coding workflows with payer expectations.
Billing Code Overview
CPT code 38226 describes a service in which the provider prepares T lymphocytes (patient-derived white blood cells) that were previously collected from the patient and places them in an appropriate container for safe transport to a laboratory. This procedure is performed as part of the workflow for CAR–T (chimeric antigen receptor T-cell) therapy, where a patient’s own T cells are modified ex vivo and returned for infusion to target cancer cells.
Service type: Specimen preparation and shipment coordination for cellular therapy
Typical site of service: Apheresis collection center, outpatient infusion center, hospital-based apheresis unit, or specialty clinic where cells are processed and packaged for laboratory transport
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with relapsed diffuse large B-cell lymphoma (DLBCL) undergoes leukapheresis to collect peripheral blood mononuclear cells for autologous chimeric antigen receptor T-cell (CAR–T) manufacturing. After standard pre-procedure evaluation, the patient presents to an outpatient apheresis suite within an academic medical center. The apheresis nurse and physician verify identity, consent, and medication status. Peripheral venous access or a temporary dual-lumen central venous catheter is used to perform leukapheresis; collected T lymphocytes are processed and recorded on site. The provider documents the preparation steps, transfers the isolated T lymphocyte product into a validated shipping container, completes chain-of-custody forms, and arranges courier pickup to the designated cellular therapy laboratory. The service is billed for the time-sensitive, preparatory handling of the patient’s previously collected T lymphocytes consistent with the logistics of CAR–T therapy.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default/standard; no modifier | Use when no other modifier applies to the service |
22 | Increased procedural services | Use when preparation required substantially greater effort or time than typical and documentation supports increased work |