CurrentFlorida BluePolicy 10-022

T-Status Procedure Code Reimbursement

Customize your policy alerts

Sign up for Florida Blue Policy 10-022 alerts

Get alerted when Policy 10-022 changes without checking for updates manually.

Monitor payer policy activity

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

Defines Florida Blue's reimbursement stance for procedure codes assigned CMS PFS status 'T' when billed on a CMS-1500 or equivalent claim form; affects all providers and lines of business billing Florida Blue members.

Policy Summary

PayerFlorida Blue

PolicyT-Status Procedure Code Reimbursement

Policy CodePolicy 10-022

Change TypeNo material change

Effective DateMay 14, 2026

Last ReviewMay 14, 2026

Next Review DateN/A

Key ActionDo not bill T-status codes for separate reimbursement when other physician fee schedule–payable services are billed the same date by the same provider; appeals to override this policy will not be accepted.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

All LOBspolicy applicability

No overridesmodifier override policy

8 codesexample codes included

05/14/2026last revision date

Reimbursement Rules for T-Status Procedure Codes

T-status reimbursement rules

Covered when ALL of the following are met:

T-status coded services have RVUs and payment amounts but are only paid if there are no other services payable under the physician fee schedule billed on the same date by the same provider.

If any other payable physician fee schedule services are billed on the same date by the same provider, T-status services are considered bundled into the services for which payment is made and are not separately reimbursed.

No modifier overrides will exempt T-status codes from bundling; modifier indicators will not change bundling treatment.

Appeals to override this policy will not be accepted.

Policy applies to services billed on a CMS-1500 or equivalent claim form and uses 'same provider' to mean physicians and/or other health care professionals reporting under the same Federal Tax Identification number.

Example T-Status Codes

Example T-status codesCPT | HCPCS

36591	Collection of blood specimen from a completely implantable venous access device
36592	Collection of blood specimen using established central or peripheral catheter, venous, not otherwise specified
36598	Contrast injection(s) for radiologic evaluation of existing central venous access device, including fluoroscopy, image documentation and report
94760	Noninvasive ear or pulse oximetry for oxygen saturation; single determination
94761	Noninvasive ear or pulse oximetry for oxygen saturation; multiple determinations (e.g., during exercise)
96523	Irrigation of implanted venous access device for drug delivery systems
G0117	Glaucoma screening for high-risk patients furnished by an optometrist or ophthalmologist
G0118	Glaucoma screening for high-risk patients furnished under the direct supervision of an optometrist or ophthalmologist

Authorization, Appeals, and Billing Notes

Denial Risk

Authorization / Appeals — No overrides; not a guarantee of payment

Appeals to override this payment policy will not be accepted; this policy is not an authorization or guarantee of payment and benefits are determined by the group contract and member benefit booklet.

THIS PAYMENT POLICY IS NOT AN AUTHORIZATION, CERTIFICATION, EXPLANATION OF BENEFITS, OR A GUARANTEE OF PAYMENT; benefits are determined by the group contract and member benefit booklet. [[chunk refs in citations array]]

Defined Terms

Same provider — definition

DefinitionAll physicians and/or other health care professionals reporting under the same Federal Tax Identification (Tax ID) number.

ScopeApplies when billing services on a CMS-1500 or equivalent claim form.

Implication for billingServices billed on the same date by providers reporting under the same Tax ID are considered from the 'same provider' for purposes of T‑status bundling rules.

T-status codes — definition and payment conditions

Core definitionT‑status codes have RVUs and payment amounts but are paid only if no other physician fee schedule–payable services are billed on the same date by the same provider.

Bundling ruleIf any other physician fee schedule–payable services are billed on the same date by the same provider, T‑status services are bundled into the paid services and are not separately reimbursed.

Modifier/override policyNo modifier overrides will exempt T‑status codes from bundling; modifier overrides are not permitted.

AppealsAppeals to override this policy will not be accepted.

ApplicabilityPolicy applies to services billed on a CMS‑1500 or equivalent claim form and uses the 'same provider' definition based on Federal Tax ID.

Policy Summary

PayerFlorida Blue

PolicyT-Status Procedure Code Reimbursement

Policy CodePolicy 10-022

Change TypeNo material change

Effective DateMay 14, 2026

Last ReviewMay 14, 2026

Next Review DateN/A

SourceLink

On This Page

OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.

CurrentFlorida BluePolicy 10-022

T-Status Procedure Code Reimbursement

Customize your policy alerts

Sign up for Florida Blue Policy 10-022 alerts

Get alerted when Policy 10-022 changes without checking for updates manually.

Monitor payer policy activity

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

Policy Summary

PayerFlorida Blue

PolicyT-Status Procedure Code Reimbursement

Policy CodePolicy 10-022

Change TypeNo material change

Effective DateMay 14, 2026

Last ReviewMay 14, 2026

Next Review DateN/A

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

All LOBspolicy applicability

No overridesmodifier override policy

8 codesexample codes included

05/14/2026last revision date

Reimbursement Rules for T-Status Procedure Codes

T-status reimbursement rules

Covered when ALL of the following are met:

T-status coded services have RVUs and payment amounts but are only paid if there are no other services payable under the physician fee schedule billed on the same date by the same provider.

No modifier overrides will exempt T-status codes from bundling; modifier indicators will not change bundling treatment.

Appeals to override this policy will not be accepted.

Example T-Status Codes

Example T-status codesCPT | HCPCS

36591	Collection of blood specimen from a completely implantable venous access device
36592	Collection of blood specimen using established central or peripheral catheter, venous, not otherwise specified
36598	Contrast injection(s) for radiologic evaluation of existing central venous access device, including fluoroscopy, image documentation and report
94760	Noninvasive ear or pulse oximetry for oxygen saturation; single determination
94761	Noninvasive ear or pulse oximetry for oxygen saturation; multiple determinations (e.g., during exercise)
96523	Irrigation of implanted venous access device for drug delivery systems
G0117	Glaucoma screening for high-risk patients furnished by an optometrist or ophthalmologist
G0118	Glaucoma screening for high-risk patients furnished under the direct supervision of an optometrist or ophthalmologist

Authorization, Appeals, and Billing Notes

Denial Risk

Authorization / Appeals — No overrides; not a guarantee of payment

Appeals to override this payment policy will not be accepted; this policy is not an authorization or guarantee of payment and benefits are determined by the group contract and member benefit booklet.

THIS PAYMENT POLICY IS NOT AN AUTHORIZATION, CERTIFICATION, EXPLANATION OF BENEFITS, OR A GUARANTEE OF PAYMENT; benefits are determined by the group contract and member benefit booklet. [[chunk refs in citations array]]

Defined Terms

Same provider — definition

DefinitionAll physicians and/or other health care professionals reporting under the same Federal Tax Identification (Tax ID) number.

ScopeApplies when billing services on a CMS-1500 or equivalent claim form.

Implication for billingServices billed on the same date by providers reporting under the same Tax ID are considered from the 'same provider' for purposes of T‑status bundling rules.

T-status codes — definition and payment conditions

Core definitionT‑status codes have RVUs and payment amounts but are paid only if no other physician fee schedule–payable services are billed on the same date by the same provider.

Modifier/override policyNo modifier overrides will exempt T‑status codes from bundling; modifier overrides are not permitted.

AppealsAppeals to override this policy will not be accepted.

ApplicabilityPolicy applies to services billed on a CMS‑1500 or equivalent claim form and uses the 'same provider' definition based on Federal Tax ID.

Policy Summary

PayerFlorida Blue

PolicyT-Status Procedure Code Reimbursement

Policy CodePolicy 10-022

Change TypeNo material change

Effective DateMay 14, 2026

Last ReviewMay 14, 2026

Next Review DateN/A

SourceLink

On This Page