CPT 96900: Ultraviolet Therapy for Skin Diseases

Medicare pays $25 and commercial payers pay $68 on average nationally for this procedure.

CPT code 96900 describes treatment using ultraviolet rays to manage skin diseases; this phototherapy service is typically delivered as dermatologic therapeutic skin treatment in an outpatient clinic or dermatology office setting and involves a provider-administered UV light procedure for conditions such as psoriasis or photodermatoses.

For related coverage guidance, see recent payer policy updates: Onychomycosis diagnostic testing and coverage, Topical Acne-Non-Retinoid Products, Dermatology - Vtama Drug Quantity Management Policy - Per Days.

Customize your policy alerts

Sign up for cpt 96900 policy alerts

Get alerted when payer policies referencing 96900 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

National Reimbursement Benchmarks

Medicare’s mean rate of $24.8 sits well below BUCA’s commercial average of $68.5, indicating a sizable gap between public reimbursement and that commercial benchmark for CPT 96900. Median and percentile values for Medicare cluster tightly (P25 $22, P50 $24, P75 $26), while BUCA’s interquartile cadence (P25 $55.1, P50 $64, P75 $82.6) reflects higher commercial pricing and broader central tendency around the mid-$60s to low-$80s.

Examining dispersion using P75–P25, Blue Cross Blue Shield shows the widest IQR at $34.2 (P75 $114.2 minus P25 $80.0). UnitedHealth Group and Cigna follow with IQRs of $22.3 and $24.5 respectively (UnitedHealth Group P75 $44.5 minus P25 $22.7; Cigna P75 $47.1 minus P25 $22.6). Aetna is the tightest among those with full percentile sets with an IQR of $8.9 (P75 $29.3 minus P25 $20.4), while BUCA’s IQR is $27.5 (P75 $82.6 minus P25 $55.1).

Explore openpayer tools

View all tools

CPT 96900: Ultraviolet Therapy for Skin Diseases

Medicare pays $25 and commercial payers pay $68 on average nationally for this procedure.

Customize your policy alerts

Sign up for cpt 96900 policy alerts

Get alerted when payer policies referencing 96900 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

National Reimbursement Benchmarks

National Payer Mean Reimbursement Rates

Clinical & Coding Specifications

Clinical Context

A 45-year-old patient with widespread plaque psoriasis presents to a dermatology clinic after failure of topical therapies. The dermatologist documents disease distribution, prior treatments, and baseline photographs. The patient is scheduled for a course of ultraviolet phototherapy delivered in a dedicated phototherapy suite. Each visit includes verification of identity, review of contraindications (photosensitivity, recent tanning, use of photosensitizing medications), measurement of minimal erythema dose or initiation of a standard starting dose, eye protection provided, and application of targeted or whole-body UVB/PUVA exposures per protocol. Treatment sessions are typically performed 2–3 times weekly over several weeks with incremental dose adjustments, documentation of dose, body surface treated, any adverse reactions, and patient tolerance. Billing uses 96900 for ultraviolet phototherapy when applicable, often accompanied by an established patient office visit code such as 99213 for evaluation or management performed the same day when medically appropriate and separately reportable.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`96910`	Photochemotherapy, tar and UVB	Alternative phototherapy modality; used for patients receiving tar combined with UVB instead of standard UV alone.
`96912`	Photochemotherapy, PUVA	Photochemotherapy using psoralen plus UVA; an alternative regimen for conditions not controlled by UVB alone.
`96567`	Photodynamic therapy, skin	Different light-based skin therapy used for lesions such as actinic keratoses; may be used on separate visits or sites.
`99213`	Established patient office visit, level 3	Evaluation and management visit often billed when a separate, documented E/M service is provided on the same day as `96900`.

Related Modifiers

8 rows

Modifier	Description	When to Use
25	CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…	- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
76	Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…	- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
77	Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…	- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
95	Modifier 95 indicates that a service was provided via synchronous, real‑time audio‑video telehealth rather than in‑person. Per CMS, AAPC and professional associations, append modifier 95 to claim…	- Use modifier 95 to indicate a service was furnished via synchronous, real‑time audiovisual telehealth (a live audio‑video conference between patient and provider) rather than in‑person. - Pair…
51	Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…	- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207N00000X	Dermatology Physician	A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genital…
207ND0101X	MOHS-Micrographic Surgery Physician	The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge o…
207NS0135X	Procedural Dermatology Physician	Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue …
207RM1200X	Magnetic Resonance Imaging (MRI) Internal Medicine Physician	The NUCC recommends this code not be used. Choose a more appropriate code.<br/>
225100000X	Physical Therapist	Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who…
364SI0800X	Informatics Clinical Nurse Specialist	Physician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist
261QL0400X	Lithotripsy Clinic/Center	Ambulatory Health Care Facilities · Clinic/Center
363LN0000X	Neonatal Nurse Practitioner	Physician Assistants & Advanced Practice Nursing Providers · Nurse Practitioner

Related Payer Policy Updates

Specialty: Dermatology1 / 2

10 rows

Policy	Payer	Effective Date
Onychomycosis diagnostic testing and coverage	Oscar Health	2026-10-01
Topical Acne-Non-Retinoid Products	Cigna	2026-08-15
Dermatology - Vtama Drug Quantity Management Policy - Per Days	Cigna	2026-08-15
Medical Necessity Guidelines: Acne and Rosacea Medications	harvard pilgrim health care	2026-08-11
Winlevi (clascoterone 1% cream) — Topical Acne	Cigna	2026-08-01
Pharmacologic Treatment of Psoriasis	Premera Bluecross	2026-08-01
Spevigo (spesolimab‑sbzo) for generalized pustular psoriasis	UnitedHealthcare	2026-08-01
Onychomycosis Testing	blue cross blue shield - louisiana	2026-08-01
Spesolimab-sbzo (Spevigo	blue cross blue shield - tennessee	2026-07-31
Home ultraviolet light therapy equipment for skin conditions	select_health	2026-07-01

CPT 96902: Hair Pluck Microscopic Analysis for Telogen/Anagen Counts

CPT-96904-DERMATOSCOPIC-EXAMINATION-WITH-IMAGING

CPT 96904: Dermatoscopy with Digital Imaging of Pigmented Lesions

CPT-96910-TAR-PETROLATUM-PLUS-UVB-PHOTOTHERAPY

CPT 96910: Tar or Petrolatum Application with UVB Phototherapy

CPT-96912-PUVA-PHOTOCHEMOTHERAPY-PSORALEN-UV-A

CPT 96912: Photochemotherapy (Psoralen + UVA)

CPT-96913-PHOTOCHEMOTHERAPY-4-TO-8-HOUR-SESSION

CPT 96913: Photochemotherapy, Prolonged (4–8 Hours)

CPT-96920-EXCIMER-LASER-TREATMENT-PSORIASIS-LESS-THAN-250-SQ-CM

CPT 96920: Excimer Laser Treatment for Psoriasis (<250 sq cm)

CPT-96921-EXCIMER-LASER-PSORIASIS-250-500-SQ-CM

CPT 96921: Excimer (UV) Laser Treatment for Psoriasis 250–500 sq cm

CPT-96922-EXCIMER-LASER-PSORIASIS-TREATMENT-OVER-500-SQCM

CPT 96922: Excimer (UV) Laser Treatment for Psoriasis, >500 sq cm

CPT-96931-SKIN-NEAR-INFRARED-IMAGING-LESION-INTERPRETATION

CPT 96931: Near-Infrared Imaging for Single Skin Lesion

CPT-96932-NEAR-INFRARED-SKIN-IMAGING-LESION-EVALUATION

CPT 96932: Near-Infrared Imaging of Single Skin Lesion

Showing 1–10 of 15

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Explore openpayer tools

View all tools

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`96910`	Photochemotherapy, tar and UVB	Alternative phototherapy modality; used for patients receiving tar combined with UVB instead of standard UV alone.
`96912`	Photochemotherapy, PUVA	Photochemotherapy using psoralen plus UVA; an alternative regimen for conditions not controlled by UVB alone.
`96567`	Photodynamic therapy, skin	Different light-based skin therapy used for lesions such as actinic keratoses; may be used on separate visits or sites.
`99213`	Established patient office visit, level 3	Evaluation and management visit often billed when a separate, documented E/M service is provided on the same day as `96900`.

Related Modifiers

8 rows

Modifier	Description	When to Use
25	CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…	- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
76	Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…	- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
77	Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…	- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
95	Modifier 95 indicates that a service was provided via synchronous, real‑time audio‑video telehealth rather than in‑person. Per CMS, AAPC and professional associations, append modifier 95 to claim…	- Use modifier 95 to indicate a service was furnished via synchronous, real‑time audiovisual telehealth (a live audio‑video conference between patient and provider) rather than in‑person. - Pair…
51	Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…	- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207N00000X	Dermatology Physician	A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genital…
207ND0101X	MOHS-Micrographic Surgery Physician	The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge o…
207NS0135X	Procedural Dermatology Physician	Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue …
207RM1200X	Magnetic Resonance Imaging (MRI) Internal Medicine Physician	The NUCC recommends this code not be used. Choose a more appropriate code.<br/>
225100000X	Physical Therapist	Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who…
364SI0800X	Informatics Clinical Nurse Specialist	Physician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist
261QL0400X	Lithotripsy Clinic/Center	Ambulatory Health Care Facilities · Clinic/Center
363LN0000X	Neonatal Nurse Practitioner	Physician Assistants & Advanced Practice Nursing Providers · Nurse Practitioner

Related Payer Policy Updates

Specialty: Dermatology1 / 2

10 rows

Policy	Payer	Effective Date
Onychomycosis diagnostic testing and coverage	Oscar Health	2026-10-01
Topical Acne-Non-Retinoid Products	Cigna	2026-08-15
Dermatology - Vtama Drug Quantity Management Policy - Per Days	Cigna	2026-08-15
Medical Necessity Guidelines: Acne and Rosacea Medications	harvard pilgrim health care	2026-08-11
Winlevi (clascoterone 1% cream) — Topical Acne	Cigna	2026-08-01
Pharmacologic Treatment of Psoriasis	Premera Bluecross	2026-08-01
Spevigo (spesolimab‑sbzo) for generalized pustular psoriasis	UnitedHealthcare	2026-08-01
Onychomycosis Testing	blue cross blue shield - louisiana	2026-08-01
Spesolimab-sbzo (Spevigo	blue cross blue shield - tennessee	2026-07-31
Home ultraviolet light therapy equipment for skin conditions	select_health	2026-07-01

CPT 96902: Hair Pluck Microscopic Analysis for Telogen/Anagen Counts

CPT-96904-DERMATOSCOPIC-EXAMINATION-WITH-IMAGING

CPT 96904: Dermatoscopy with Digital Imaging of Pigmented Lesions

CPT-96910-TAR-PETROLATUM-PLUS-UVB-PHOTOTHERAPY

CPT 96910: Tar or Petrolatum Application with UVB Phototherapy

CPT-96912-PUVA-PHOTOCHEMOTHERAPY-PSORALEN-UV-A

CPT 96912: Photochemotherapy (Psoralen + UVA)

CPT-96913-PHOTOCHEMOTHERAPY-4-TO-8-HOUR-SESSION

CPT 96913: Photochemotherapy, Prolonged (4–8 Hours)

CPT-96920-EXCIMER-LASER-TREATMENT-PSORIASIS-LESS-THAN-250-SQ-CM

CPT 96920: Excimer Laser Treatment for Psoriasis (<250 sq cm)

CPT-96921-EXCIMER-LASER-PSORIASIS-250-500-SQ-CM

CPT 96921: Excimer (UV) Laser Treatment for Psoriasis 250–500 sq cm

CPT-96922-EXCIMER-LASER-PSORIASIS-TREATMENT-OVER-500-SQCM

CPT 96922: Excimer (UV) Laser Treatment for Psoriasis, >500 sq cm

CPT-96931-SKIN-NEAR-INFRARED-IMAGING-LESION-INTERPRETATION

CPT 96931: Near-Infrared Imaging for Single Skin Lesion

CPT-96932-NEAR-INFRARED-SKIN-IMAGING-LESION-EVALUATION

CPT 96932: Near-Infrared Imaging of Single Skin Lesion

Showing 1–10 of 15

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

CPT 96900: Ultraviolet Therapy for Skin Diseases

Sign up for cpt 96900 policy alerts

National Reimbursement Benchmarks

OpenPayer

CPT 96900: Ultraviolet Therapy for Skin Diseases

Sign up for cpt 96900 policy alerts

National Reimbursement Benchmarks

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

References

CPT 96900: Ultraviolet Therapy for Skin Diseases

Sign up for cpt 96900 policy alerts

National Reimbursement Benchmarks

CPT 96900: Ultraviolet Therapy for Skin Diseases

Sign up for cpt 96900 policy alerts

National Reimbursement Benchmarks

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

What clinical situations justify billing CPT 96900?

Can an office visit be billed on the same day as 96900?

What elements of each phototherapy visit should be documented?

How does CPT 96900 relate to other phototherapy CPT codes like 96910 or 96912?

Which payers are noted as covering this service on the page?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

What clinical situations justify billing CPT 96900?

Can an office visit be billed on the same day as 96900?

What elements of each phototherapy visit should be documented?

How does CPT 96900 relate to other phototherapy CPT codes like 96910 or 96912?

Which payers are noted as covering this service on the page?

References