CPT is a registered trademark of the American Medical Association (AMA). The AMA develops and maintains CPT code set through the CPT Editorial Panel.
CPT (Current Procedural Terminology) codes are five-digit (alphanumeric) numbers assigned to various tasks and services a medical practitioner (physician or non-physician) may provide to a patient including medical, surgical and diagnostic services. These codes are used by insurers to determine the amount of reimbursement that a practitioner will receive by an insurer for performing a specific service. Each CPT code ensures uniform meaning among physicians, coders, patients, accreditation organizations, and payers for administrative, financial, and analytical purposes.
There are three types of CPT codes:
- Category I CPT Code(s)
- Category II CPT Code(s) – Performance Measurement
- Category III CPT Code(s) – Emerging Technology
CPT describes almost every possible existing medical services provided by a physician with a unique code. For example, an Evaluation and Management service can be indicated with a code 99215, a radiology procedure by code 71010, a cardiology surgical procedure by using code 33510 and so on.
Payment or reimbursement by an insurer or payer to a physician depends primarily upon CPT codes. Apart from CPT codes, the other payment factors are RVUs (Relative Value Unit), Conversion Factor, geographical locations etc. that directly affect the payment amount.