CurrentHumanaPolicy CP2015012

Modifier CT (CT services on non–NEMA XR-29-2013 compliant equipment)

Defines Humana's billing and reimbursement requirements for CT services reported with modifier CT for Medicare Advantage, Commercial and Medicaid products and explains the payment reduction applied to the technical component when CT equipment does not meet NEMA XR-29-2013 attributes.

Policy Summary

PayerHumana

PolicyModifier CT (CT services on non–NEMA XR-29-2013 compliant equipment)

Policy CodePolicy CP2015012

Change TypeNo material change

Effective Date

Next Review Date

Key ActionReport modifier CT with procedure codes for applicable CT services performed on equipment that does not meet all four attributes of NEMA XR-29-2013; pre-authorization requirements may apply.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

5%reduction to technical component for 2016 dates of service

15%reduction to technical component for dates of service beginning 2017-01-01

1Humana claims payment policy number referenced

4attributes required by NEMA XR-29-2013 standard (equipment must meet all)

Modifier CT Reimbursement Criteria

Modifier CT reimbursement criteria

When modifier CT is reported on applicable CT service claims:

Modifier CT is reported when CT services are performed on equipment that does not meet all four attributes of NEMA Standard XR-29-2013 (MITA Smart Dose).

Humana reduces reimbursement for the technical component (TC) of the applicable CT service by 5% for dates of service in 2016.

Humana reduces reimbursement for the technical component (TC) of the applicable CT service by 15% for dates of service beginning January 1, 2017.

Exemption: Medicaid plans that do not apply the modifier CT payment reduction are exempt from this policy.

Policy Summary

PayerHumana

PolicyModifier CT (CT services on non–NEMA XR-29-2013 compliant equipment)

Policy CodePolicy CP2015012

Change TypeNo material change

Effective Date

Next Review Date

SourceLink

On This Page

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.

Claims remain subject to other plan requirements such as medical necessity, reasonableness, and applicable referral or authorization rules; pre-authorization requirements may apply.

Modifier and TC Payment Details

ModifierModifier

Modifier CT

Used to indicate CT services furnished using equipment that does not meet each of the attributes of NEMA XR-29-2013.

TC payment reduction thresholds

2016 TC payment reductionHumana reduces reimbursement for the technical component (TC) by 5% for dates of service in 2016.

2017+ TC payment reductionHumana reduces reimbursement for the technical component (TC) by 15% for dates of service beginning January 1, 2017.

Scope of reductionApplies when modifier CT is reported on an applicable CT service claim performed on equipment that does not meet all four NEMA XR-29-2013 attributes.

Provider Reporting and Authorization

Prior Authorization

Report modifier CT; pre-authorization may be required

Humana requires providers to report modifier CT with the procedure code(s) when CT services are performed on equipment that does not meet all four attributes of NEMA Standard XR-29-2013; pre-authorization requirements may apply for applicable CT services.

Report modifier CT on claims for applicable CT services performed on non–NEMA XR-29-2013 compliant equipment.
Be aware that pre-authorization requirements may apply for these services.

Key Definitions

Applicable CT services

DefinitionApplicable CT services are computed tomography services identified by CMS as subject to the modifier CT payment reduction rule.

When to reportModifier CT is reported with procedure codes for these applicable CT services when performed on non‑compliant equipment.

Policy applicationMedicaid plans that do not apply the modifier CT payment reduction are exempt from this policy.

Modifier CT

Modifier nameModifier CT

DefinitionUsed to indicate computed tomography services furnished using equipment that does not meet each of the attributes of the NEMA XR‑29‑2013 standard.

Usage instructionProviders must report modifier CT with procedure codes for applicable CT services performed on non‑compliant equipment.

Technical component (TC)

TermTechnical component (TC)

DefinitionThe TC covers all non‑physician work and includes administrative, personnel and capital (equipment and facility) costs and related malpractice expenses.

Billing noteModifier TC is used with the billing code to indicate that the technical component is being billed.