2025 CPT code 96920

Excimer laser treatment for psoriasis; total treatment area less than 250 sq cm.

Refer to the AMA CPT codebook and related guidelines for proper coding and billing practices.

Modifiers such as -22 (Increased Procedural Services), -59 (Distinct Procedural Service), and -76 (Repeat Procedure or Service by Same Physician) might be applicable in certain situations. Refer to the current CPT guidelines for appropriate modifier use.

Medical necessity is established by the presence of psoriasis affecting a localized area of the skin.The excimer laser is a medically reasonable and necessary treatment option for mild-to-moderate psoriasis in appropriately selected patients, especially when topical treatments have failed or are inadequate.

The physician or qualified healthcare professional prepares the patient, operates the excimer laser device, and precisely targets the psoriatic lesions with the laser beam, adjusting parameters as needed for optimal treatment. Post-procedure monitoring and patient education are included.

IMPORTANT For intralesional injections, see CPT codes 11900 and 11901. For Tzanck smear, see CPT codes 88160-88161. Codes 96921 and 96922 cover larger treatment areas.

In simple words: This code covers a treatment for psoriasis using a special ultraviolet laser. The laser light targets only the psoriasis patches, keeping the healthy skin safe. This type of treatment is done for areas smaller than about 250 square centimeters (a little bigger than a sheet of paper).

This CPT code 96920 represents the application of excimer laser therapy (using ultraviolet light) to treat psoriasis.The treatment is limited to a total area of less than 250 square centimeters. The procedure involves precisely targeting psoriatic plaques with a concentrated dose of UVB light (308 nm wavelength), aiming to reduce the appearance of lesions and provide relief from symptoms.The excimer laser's concentrated beam minimizes exposure of healthy skin to UV radiation.

Example 1: A 35-year-old patient presents with plaque psoriasis affecting the elbows and knees. The total area affected is 150 sq cm.The physician performs excimer laser treatment. , A 60-year-old patient with psoriasis on their scalp (total area 200 sq cm) undergoes multiple excimer laser treatments over several weeks. Each session is billed separately. , A 22-year-old patient with localized psoriasis on their hands and feet (total area 240 sq cm) receives excimer laser treatment as part of a comprehensive psoriasis management plan that includes topical medications.

Detailed medical history, including extent and severity of psoriasis.Pre-treatment photographs of the affected areas.Documentation of the total treatment area (in sq cm).Laser settings used (e.g., fluence, pulse duration).Post-treatment assessment of response to therapy.

** The treatment area must be accurately measured to select the appropriate code (96920, 96921, or 96922).Appropriate documentation is essential for accurate billing and reimbursement.

  • Revenue Code: P6A (MINOR PROCEDURES - SKIN)
  • RVU: Refer to the Medicare Physician Fee Schedule (MPFS) for current reimbursement rates. RVUs vary based on geographic location and other factors.
  • Global Days : Information not specified in provided data; this will vary based on payer and individual circumstances.
  • Payment Status: Active
  • Modifier TC rule: No TC modifier applies to 96920, as it represents a complete service.
  • Fee Schedule : Data not available in sources; refer to the CMS website for historical fee schedules.
  • Specialties:Dermatology
  • Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center
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