LCD Reference Article Billing and Coding Article

Billing and Coding: Independent Diagnostic Testing Facility (IDTF)

A57807

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Contractor Information

Contractor Name	Contract Type	Contract Number	Jurisdiction	States
First Coast Service Options, Inc.	A and B MAC	09102 - MAC B	J - N	Florida
First Coast Service Options, Inc.	A and B MAC	09202 - MAC B	J - N	Puerto Rico
First Coast Service Options, Inc.	A and B MAC	09302 - MAC B	J - N	Virgin Islands

Article Information

General Information

Article ID
A57807

Article Title
Billing and Coding: Independent Diagnostic Testing Facility (IDTF)

Article Type
Billing and Coding

Original Effective Date
10/03/2018

Revision Effective Date
11/07/2024

Revision Ending Date
N/A

Retirement Date
N/A

Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

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Making copies or utilizing the content of the UB‐04 Manual, including the codes and/or descriptions, for internal purposes, resale and/or to be used in any product or publication; creating any modified or derivative work of the UB‐04 Manual and/or codes and descriptions; and/or making any commercial use of UB‐04 Manual or any portion thereof, including the codes and/or descriptions, is only authorized with an express license from the American Hospital Association. The American Hospital Association (the "AHA") has not reviewed, and is not responsible for, the completeness or accuracy of any information contained in this material, nor was the AHA or any of its affiliates, involved in the preparation of this material, or the analysis of information provided in the material. The views and/or positions presented in the material do not necessarily represent the views of the AHA. CMS and its products and services are not endorsed by the AHA or any of its affiliates.

CMS National Coverage Policy

Internet-Only Manuals (IOMs)

CMS IOM Publication 100-02, Medicare Benefit Policy Manual,
- Chapter 15, Section 60, Services and Supplies Furnished Incident to a Physician/NPP professional service, Section 80, Requirements for Diagnostic Xray, Diagnostic Laboratory, and Other Diagnostic Tests

CMS IOM Publication 100-04, Medicare Claims Processing Manual,
- Chapter 1, Section 10.1.1 Payment Jurisdictions Among A/B MACS (B) for Services Paid Under the Physician Fee Schedule and Anesthesia Services, Section 30.2 Assignment of Provider’s Right to Payment
- Chapter 35, Independent Diagnostic Testing Facility (IDTF)

CMS IOM Publication 100-08, Medicare Program Integrity Manual,
- Chapter 3, Section 3.2.3.3 Third-Party Additional Documentation Request
- Chapter 10, Section 10.2.2.4 Independent Diagnostic Testing Facilities (IDTFs)

Social Security Act (Title XVIII) Standard References:

Title XVIII of the Social Security Act, Section 1833(e) states that no payment shall be made to any provider of services or other person under this part unless there has been furnished such information as may be necessary in order to determine the amounts due such provider or other person under this part for the period with respect to which the amounts are being paid or for any prior period.

Code of Federal Regulations (CFR) References:

CFR, Title 42, Chapter IV, Part 410 §410.32(a) Ordering diagnostic tests
CFR, Title 42, Chapter IV, Part 410 §410.33 Independent diagnostic testing facility

Article Guidance

Article Text

This Billing and Coding Article provides billing and coding guidance for Independent Diagnostic Testing Facilities (IDTFs). Diagnostic testing performed in an IDTF must follow the supervision and credentialing guidelines set forth in this Local Coverage Article. All enrolling IDTFs must meet the supervising physician qualification/proficiency requirements and technician qualification requirements at the time of their enrollment.

Coding Guidance

IDTFs are required to report the exact CPT/HCPCS codes/procedures they intend to perform when enrolling with the CMS-855B form. If an IDTF which is already enrolled wants to perform additional CPT or HCPCS code tests that were not originally specified on its CMS-855B and that are for procedure types and supervision levels similar to its previously allowed codes, the contractor shall have the IDTF amend its CMS-855B to add the additional codes and equipment listing. A new site visit is not required. However, if the enrolled IDTF will be performing CPT or HCPCS codes for different types of procedures, or with different supervision levels, a new site visit is required. Claims submitted with procedure codes not reported on the CMS-855B form and reviewed by the contractor will be denied.

Each IDTF will have a specific and unique list of CPT/HCPCS codes for which it can be paid by the contractor, and it is the responsibility of the IDTF to obtain specific contractor approval to bill each CPT/HCPCS code that it intends to bill. Based on equipment and personnel requirements, IDTFs are required to submit a list of all procedure codes performed by the facility to Medicare Provider Enrollment. The codes and equipment should be listed on Attachment 2, Section 1 of Enrollment Application Form CMS-855B.

Desk and Site Reviews

All new IDTF applications shall receive a thorough desk review, and a mandatory site review prior to the contractor's enrollment of the applicant and issuance of a billing number. The general purpose of both reviews is to determine whether the information listed on Attachment 2 of the CMS-855B is correct, verifiable, and in accordance with IDTF regulatory and manual requirements.

Site Visits for Mobile Units and Electronic Monitoring Services

Mobile units are required to list their geographic service area. They can be site visited by the following methods:

The mobile unit may visit the office of the site reviewer, OR
The site reviewer can obtain an advance schedule of the locations the IDTF will be visiting and conduct the site visit at one of those locations.

Transtelephonic and electronic monitoring services (e.g., 24-hour ambulatory EKG monitoring; pacemaker monitoring and cardiac event detection) should be classified as IDTFs and must meet all IDTF requirements. These entities require a supervisory physician who performs general supervision. Final enrollment of a transtelephonic or electronic monitoring service, such as an IDTF, requires a site visit.

Additional information may be found in CMS Internet-Only Manual (IOM) Publication 100-04, Medicare Claims Processing Manual, Chapter 35, Independent Diagnostic Testing Facility (IDTF).

Supervising Physicians

An IDTF must have one or more supervising physicians who are responsible for the direct and ongoing oversight of the quality of the testing performed, the proper operation and calibration of the equipment used to perform tests, and the qualifications of non-physician personnel who use the equipment.

Not every supervising physician has to be responsible for all these functions. These responsibilities may be divided among the supervising physicians. For example, one supervising physician may be responsible only for the operation and calibration of the equipment, while other supervising physicians are responsible for test supervision and/or the qualifications of the non-physician personnel.

Additional information may be found in the CMS IOM Publication 100-02, Chapter 15, Section 80 and 42 CFR §410.32(b) and §410.33.

Non-Physician Personnel

The contractor does not establish a credentialing service, but the contractor is authorized to determine which organizations it recognizes. For example, the use of the word “national” in the organization’s name does not, in itself, meet Medicare standards for national credentialing.

The supervising physician and non-physician personnel credentialing requirements are listed below in the Credentialing Matrix.

Additional information may be found in the CMS IOM Publication100-02, Chapter 15, Sections 80.2, 80.3, and 190 as well as 42 CFR §410.33.

Interpreting Physicians

An IDTF is not restricted to billing only the technical component of diagnostic services. In certain situations, an IDTF can bill for both the technical component of the diagnostic test and interpretative services. This approach is referred to as billing "globally". The interpretative services must be performed by a licensed practitioner who is allowed to perform the service.

When enrolling or updating information, the IDTF shall list all physicians for whose diagnostic test interpretations it will bill. This includes physicians who are providing purchased interpretations to the IDTF (in accordance with CMS Manual System, Pub. 100-04, Medicare Claims Processing Manual, Chapter 1, Section 30.2), as well as physicians who are reassigning their benefits to the IDTF. The contractor will ensure and document the following:

All physicians listed are enrolled in Medicare.
All interpreting physicians who are reassigning their benefits to the IDTF have the right to do so.
All required CMS-855R forms have been submitted.
The interpreting physicians listed are qualified to interpret the types of tests (codes) listed. In accordance with this CMS requirement (CMS Manual System, Pub. 100-08, Medicare Program Integrity Manual, Chapter 15, Section 15.5.19.3).

Note: The applicant cannot bill globally for interpreting physicians not listed.

If an interpreting physician has been recently added or changed, the new interpreting physician must have met all of the interpreting physician requirements at the time any tests were performed.

Off-Site Interpretations

If an IDTF wants to bill for an interpretation performed by an independent practitioner off the premises of the IDTF, it must meet all instructions identified in the CMS Manual System, Pub. 100-04, Medicare Claims Processing Manual, Chapter 1, concerning purchased interpretations. In this scenario, there is no reassignment of benefits because the purchaser of the test is also considered the supplier of the test.

When the technical component of a test is performed by the IDTF and the interpreting practitioner is the practitioner who ordered the test, the IDTF cannot bill for the interpretation. The interpreting practitioner must bill the interpretation since the IDTF cannot bill the interpretation when the interpreting physician is the referring physician.

Purchased Diagnostic Tests and Jurisdictional Pricing

Services that are reimbursed under the Medicare Physician Fee Schedule (MPFS) are reimbursed by the payment locality where the service is furnished and by the zip code. Contractors must use the zip code of the location where the service was rendered to determine contractor jurisdiction over the claim and the correct payment locality.

When a physician, practitioner, or supplier furnishes services in payment localities that cover more than one contractor's service area (e.g., the provider has separate offices in multiple localities and/or multiple contractors), separate claims must be submitted to the appropriate contractor for processing.

Providers may not submit a global billing code on paper or electronic claims when one component of the service has been purchased. Only one service facility location (name, address and zip code) can be indicated in item 32 on the CMS-1500 form. Claims received with global services will be returned as unprocessable.

Suppliers (including laboratories, physicians, and IDTFs) must bill their local contractor for all purchased diagnostic tests/interpretations, regardless of the location where the purchased service was rendered.

Purchased Technical Components

A physician may bill for the technical component of a diagnostic test that he/she purchased from another physician, medical group or supplier. However, in order to purchase a diagnostic test from another physician, medical group, or supplier, the purchaser must perform the interpretation (professional component). Additionally, the physician or supplier that furnished the technical component must be enrolled in the Medicare program.

Purchased Interpretations

A person or entity that provides diagnostic tests may submit the claim and, if assignment is accepted, receive the Part B payment for diagnostic test interpretations which that person or entity purchases from an independent physician or medical group if:

The tests are initiated by a physician or medical group which is independent of the person or entity providing the tests and of the physician or medical group providing the interpretations;
The physician or medical group providing the interpretations does not see the patient;
The purchaser (or employee, partner, or owner of the purchaser) performs the technical component of the test. The interpreting physician must be enrolled in the Medicare program. No formal reassignment is necessary; AND
The purchaser must keep on file the name, the provider identification number and address of the interpreting physician.

Note: This does not remove the requirement that when an entity either purchases an interpretation or a test, they must perform the other component in order to be paid for the purchased component.

In order to price claims correctly and apply purchase price limitations, global billing is not acceptable for claims received on the Form CMS-1500 or on the ANSI X12N 837 electronic format. Each component must be billed as a separate line item (or on a separate claim).

Suppliers (including laboratories, physicians, and IDTFs) must submit claims for all purchased diagnostic tests/interpretations to their local contractor, regardless of the location where the purchased service was furnished.

Additional Services/Supplies

Additional services/items (e.g., radiopharmaceutical agents, special contrast agents, medications, etc.) related to, or generally considered required for, performing a diagnostic test are also payable to an IDTF if they are commonly separately reimbursed to a physician in a physician’s office setting.

An IDTF can bill these practitioner services when they are performed by a qualified practitioner in accordance with coverage, payment, and general billing rules, and in accordance with the reassignment of benefit and purchased test rules.

These additional services/items which are necessary for the performance of specific diagnostic tests may be billed by an IDTF if approval is granted by the contractor for the IDTF to bill for the specific test(s) that require such items/services. For example, some procedures require an injection of a joint for arthrography and would be allowed if the procedure is integral to the diagnostic test the IDTF is permitted to perform.

However, an IDTF is not allowed to bill for surgical procedures that are clearly not related to or required for a diagnostic test.

At the time that the IDTF requests contractor approval to perform the tests, the IDTF must identify all such items/services that it intends to bill in conjunction with specific tests.

JW and JZ Modifiers

When billing for Part B drugs and biologicals (except those provided under a competitive acquisition program [CAP]), the use of the JW modifier to identify unused drugs or biologicals from single use vials or single use packages that are appropriately discarded is required. The discarded amount shall be billed on a separate claim line using the JW modifier. Providers are required to document the discarded drug or biological in the patient’s medical record.

Any amount wasted must be clearly documented in the medical record and should include the date and time, amount of medication wasted, and the reason for the wastage.

The use of the JZ modifier (attesting that there were no discarded amounts) is required on claims to report there are no discarded amounts of unused drugs or biologicals from single use vials or single use packages.

Claims for drugs separately payable under Medicare Part B from single-dose containers are required to report either the JW or JZ modifier, to identify any discarded amounts or to attest that there are no discarded amounts, respectively.

The JW and JZ modifier policy does not apply for drugs that are not separately payable, such as packaged OPPS or ASC drugs, or drugs administered in the FQHC or RHC setting.

The JW and JZ modifiers do not apply to drugs assigned status indicator N (Items and Services Packaged into APC Rates) under the OPPS. Similarly, the JW and JZ modifiers do not apply to drugs assigned payment indicator “N1” (ASC).

Documentation Requirements

All documentation must be maintained in the patient's medical record and made available to the contractor upon request.
Every page of the record must be legible and include appropriate patient identification information (e.g., complete name, dates of service[s]). The documentation must include the legible signature of the physician or non-physician practitioner responsible for and providing the care to the patient.
The submitted medical record must support the use of the selected ICD-10-CM code(s). The submitted CPT/HCPCS code must describe the service performed.
Medical record documentation maintained by the IDTF must include the information listed below and be available upon request:

Written order from the treating physician, and
Hard copy documentation of the test results and interpretation.

The IDTF must maintain documentation to demonstrate the required physician supervision requirements were met. Also, the IDTF must maintain documentation of sufficient physician resources during all hours of operation to assure that the required physician supervision is furnished.
Multi-state entities must maintain evidence that supervising physicians are licensed to practice in the state(s) where the diagnostic tests are performed and the technicians performing the diagnostic test(s) are credentialed appropriately in each state in which services are performed in accordance with requirements outlined in this article.
Documentation maintained by the IDTF must support that the personnel performing the diagnostic test(s) have the training and proficiency as evidenced by current licensure or certification as outlined in this article. This documentation must contain verification by the supervising physician(s).

Physician Supervision of Diagnostic Procedures

Supervision Level	Description
01	Procedure must be performed under the general supervision of a physician.
02	Procedure must be performed under the direct supervision of a physician.
03	Procedure must be performed under the personal supervision of a physician.
04	Physician supervision policy does not apply when procedure is furnished by a qualified, independent psychologist or a clinical psychologist. Otherwise, the procedure must be performed under the general supervision of a physician.
05	Physician supervision policy does not apply when procedure is furnished by a qualified audiologist; otherwise, must be performed under the general supervision of a physician.
06	Procedure must be personally performed by a physician or a Physical Therapist (PT) who is certified by the American Board of Physical Therapy Specialties (ABPTS) as a qualified electrophysiological clinical specialist and is permitted to provide the procedure under State law. Procedure may also be performed by a PT with ABPTS certification without physician supervision.
21	Procedure may be performed by a technician with certification under general supervision of a physician. Otherwise, the procedure must be performed under direct supervision of a physician. Procedure may also be performed by a PT with ABPTS certification without physician supervision.
22	May be performed by a technician with on-line real-time contact with a physician.
66	May be personally performed by a physician or by a PT with ABPTS certification and certification in this specific procedure.
6A	Supervision standards for level 66 apply; in addition, the PT with ABPTS certification may personally supervise another PT, but only the PT with ABPTS certification may bill.
77	Procedure must be performed by a PT with ABPTS certification (TC & PC) or by a PT without certification under direct supervision of a physician (TC & PC), or by a technician with certification under general supervision of a physician (TC only; PC always physician).
7A	Supervision standards for level 77 apply; in addition, the PT with ABPTS certification may personally supervise another PT, but only the PT with ABPTS certification may bill.
09	Concept does not apply.

The provider is responsible for adhering to applicable CMS regulations for diagnostic test supervision.

Credentialing Matrix

The following table reflects CMS supervision requirements, which describes the levels of physician supervision required for furnishing the technical component of diagnostic tests for Medicare beneficiaries who are not a hospital inpatient or outpatient.

*American Board of Medical Specialty (ABMS), American Board of Nuclear Medicine (ABNM), American Board of Physical Medicine and Rehabilitation (ABPMR), American Board of Psychiatry and Neurology (ABPN), American Osteopathic Association (AOA), or subspecialty certification.

CPT/HCPCS CODES	LEVEL OF PHYSICIAN SUPERVISION	SUPERVISING PHYSICIAN QUALIFICATION REQUIREMENTS	TECHNICIAN QUALIFICATION REQUIREMENTS
10005	09	Board Certified* Radiologist	Credentialed by ARRT in ultrasound
10006	09	Board Certified* Radiologist	Credentialed by ARRT in ultrasound
10007	09	Board Certified* Radiologist	Credentialed by ARRT in fluoroscopy
10008	09	Board Certified* Radiologist	Credentialed by ARRT in fluoroscopy
10009	09	Board Certified* Radiologist	Credentialed by ARRT in CT
10010	09	Board Certified* Radiologist	Credentialed by ARRT in CT
10011	09	Board Certified* Radiologist	Credentialed by ARRT in MRI
10012	09	Board Certified* Radiologist	Credentialed by ARRT in MRI
10021	09	Board Certified* Physician	N/A
19000	09	Board Certified* Radiologist or Surgeon	General Radiographer or Credentialed by ARRT: R.T.-R or ARRT: R.T.-M or ARDMS: RDMS or RT BS or ARRT: MR or ARMRIT: MRI
19001	09	Board Certified* Radiologist or Surgeon	General Radiographer or Credentialed by ARRT: R.T.-R or ARRT: R.T.-M or ARDMS: RDMS or RT BS or ARRT: MR or ARMRIT: MRI
19081	09	Board Certified* Radiologist or Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R or ARRT: R.T.-M or ARDMS: RDMS or RT BS or ARRT: MR or ARMRIT: MRI
19082	09	Board Certified* Radiologist or Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R or ARRT: R.T.-M or ARDMS: RDMS or RT BS or ARRT: MR or ARMRIT: MRI
19083	09	Board Certified* Radiologist or Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R or ARRT: R.T.-M or ARDMS: RDMS or RT BS or ARRT: MR or ARMRIT: MRI
19084	09	Board Certified* Radiologist or Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R or ARRT: R.T.-M or ARDMS: RDMS or RT BS or ARRT: MR or ARMRIT: MRI
19085	09	Board Certified* Radiologist or Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R or ARRT: R.T.-M or ARDMS: RDMS or RT BS or ARRT: MR or ARMRIT: MRI
19086	09	Board Certified* Radiologist or Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R or ARRT: R.T.-M or ARDMS: RDMS or RT BS or ARRT: MR or ARMRIT: MRI
19281	09	Board Certified* Radiologist or Surgeon	General Radiographer or Credentialed by ARRT: R.T.-R or ARRT: R.T.-M or ARDMS: RDMS or RT BS or ARRT: MR or ARMRIT: MRI
19283	09	Board Certified* Radiologist or Surgeon	General Radiographer or Credentialed by ARRT: R.T.-R or ARRT: R.T.-M or ARDMS: RDMS or RT BS or ARRT: MR or ARMRIT: MRI
19285	09	Board Certified* Radiologist or Surgeon	General Radiographer or Credentialed by ARRT: R.T.-R or ARRT: R.T.-M or ARDMS: RDMS or RT BS or ARRT: MR or ARMRIT: MRI
20501	09	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
23350	09	Board Certified* Radiologist or Orthopedist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
24220	09	Board Certified* Radiologist or Orthopedist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
25246	09	Board Certified* Radiologist or Orthopedist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
27369	09	Board Certified* Radiologist or Orthopedist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R or ARRT: R.T.-CT or R.T.- MR or ARMRIT: MRI
27648	09	Board Certified* Radiologist, Orthopedist or Podiatrist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
27093	09	Board Certified* Radiologist or Orthopedist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
27095	09	Board Certified* Radiologist or Orthopedist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
36901	09	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
42550	09	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
43754	09	Board Certified* Gastroenterologist	RN
43755	09	Board Certified* Gastroenterologist	RN
47531	09	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
47532	09	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
47544	09	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
51600	09	Board Certified* Radiologist or Urologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
51610	09	Board Certified* Radiologist or Urologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
51725	02	Board Certified* Urologist	Urology or OB/GYN Personally Trained Staff
51726	02	Board Certified* Urologist	Urology or OB/GYN Personally Trained Staff
51727	02	Board Certified* Urologist	Urology or OB/GYN Personally Trained Staff
51728	02	Board Certified* Urologist	Urology or OB/GYN Personally Trained Staff
51729	02	Board Certified* Urologist	Urology or OB/GYN Personally Trained Staff
51736	02	Board Certified* Urologist	Urology or OB/GYN Personally Trained Staff
51741	02	Board Certified* Urologist	Urology or OB/GYN Personally Trained Staff
51784	02	Board Certified* Urologist, Neurologist or Physiatrist	Urology or OB/GYN Personally Trained Staff
51785	03	Board Certified* Urologist, Neurologist or Physiatrist	Urology or OB/GYN Personally Trained Staff
51792	02	Board Certified* Urologist, Neurologist or Physiatrist	Urology or OB/GYN Personally Trained Staff
51797	02	Board Certified* Urologist	Urology or OB/GYN Personally Trained Staff
51798	09	Board Certified* Urologist or Radiologist	Urology or OB/GYN Personally Trained Staff or State License: General Radiographer or Credentialed by ARRT: R.T.-R
54240	02	Board Certified* Urologist	Credentialed by ARDMS: RVT or CCI: RVS
54250	01	Board Certified* Urologist	Credentialed by ARDMS: RVT or CCI: RVS
58340	09	Board Certified* Radiologist or Gynecologist	Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S
59025	01	Board Certified* Obstetrics/Gynecology	RN
62284	09	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
62302	09	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
62303	09	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
62304	09	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
62305	09	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
70010	09	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
70015	03	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
70030	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
70100	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
70110	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
70120	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
70130	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
70134	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
70140	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
70150	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
70160	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
70170	03	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
70190	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
70200	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
70210	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
70220	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
70240	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
70250	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
70260	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
70300	01	Board Certified* Radiologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
70310	01	Board Certified* Radiologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
70320	01	Board Certified* Radiologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
70328	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
70330	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
70332	03	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Credentialed by ARRT: R.T.-R
70336	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: MR or ARMRIT: MRI
70350	01	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
70355	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Credentialed by ARRT: R.T.-R
70360	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
70370	03	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
70371	03	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
70380	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
70390	03	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Credentialed by ARRT: R.T.-R
70450	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
70460	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
70470	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
70480	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
70481	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
70482	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
70486	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
70487	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
70488	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
70490	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
70491	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
70492	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
70496	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
70498	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
70540	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: MR or ARMRIT: MRI
70542	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: MR or ARMRIT: MRI
70543	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: MR or ARMRIT: MRI
70544	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: MR or ARMRIT: MRI
70545	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: MR or ARMRIT: MRI
70546	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: MR or ARMRIT: MRI
70547	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: MR or ARMRIT: MRI
70548	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: MR or ARMRIT: MRI
70549	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: MR or ARMRIT: MRI
70551	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: MR or ARMRIT: MRI
70552	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: MR or ARMRIT: MRI
70553	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: MR or ARMRIT: MRI
70554	02	Board Certified* Radiologist	Credentialed by ARRT: MR or ARMRIT: MRI
70555	02	Board Certified* Radiologist	Credentialed by ARRT: MR or ARMRIT: MRI
71045	01	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
71046	01	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
71047	01	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
71048	01	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
71100	01	Board Certified* Radiologist	State License: General Radiographer or ARRT: R.T.-R
71101	01	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
71110	01	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
71111	01	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
71120	01	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
71130	01	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
71250	01	Board Certified* Radiologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
71260	02	Board Certified* Radiologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
71270	02	Board Certified* Radiologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
71271	09	Board Certified* Radiologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
71275	02	Board Certified* Radiologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
71550	01	Board Certified* Radiologist	Credentialed by ARRT: MR or ARMRIT: MRI
71551	02	Board Certified* Radiologist	Credentialed by ARRT: MR or ARMRIT: MRI
71552	02	Board Certified* Radiologist	Credentialed by ARRT: MR or ARMRIT: MRI
71555	02	Board Certified* Radiologist	Credentialed by ARRT: MR or ARMRIT: MRI
72020	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
72040	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
72050	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
72052	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
72070	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
72072	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
72074	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
72080	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
72081	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
72082	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
72083	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
72084	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
72100	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
72110	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
72114	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
72120	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
72125	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
72126	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
72127	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
72128	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
72129	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
72130	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
72131	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
72132	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
72133	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
72141	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: MR or ARMRIT: MRI
72142	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: MR or ARMRIT: MRI
72146	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: MR or ARMRIT: MRI
72147	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: MR or ARMRIT: MRI
72148	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: MR or ARMRIT: MRI
72149	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: MR or ARMRIT: MRI
72156	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: MR or ARMRIT: MRI
72157	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: MR or ARMRIT: MRI
72158	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: MR or ARMRIT: MRI
72159	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: MR or ARMRIT: MRI
72170	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
72190	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
72191	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
72192	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
72193	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
72194	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
72195	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: MR or ARMRIT: MRI
72196	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: MR or ARMRIT: MRI
72197	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: MR or ARMRIT: MRI
72198	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: MR or ARMRIT: MRI
72200	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
72202	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
72220	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
72240	03	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
72255	03	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
72265	03	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
72270	03	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
72285	03	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
72295	03	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73000	01	Board Certified* Radiologist or Orthopaedic Surgeon	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73010	01	Board Certified* Radiologist or Orthopaedic Surgeon	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73020	01	Board Certified* Radiologist or Orthopaedic Surgeon	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73030	01	Board Certified* Radiologist or Orthopaedic Surgeon	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73040	03	Board Certified* Radiologist or Orthopaedic Surgeon	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73050	01	Board Certified* Radiologist or Orthopaedic Surgeon	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73060	01	Board Certified* Radiologist or Orthopaedic Surgeon	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73070	01	Board Certified* Radiologist or Orthopaedic Surgeon	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73080	01	Board Certified* Radiologist or Orthopaedic Surgeon	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73085	03	Board Certified* Radiologist or Orthopaedic Surgeon	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73090	01	Board Certified* Radiologist or Orthopaedic Surgeon	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73092	01	Board Certified* Radiologist or Orthopaedic Surgeon	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73100	01	Board Certified* Radiologist or Orthopaedic Surgeon	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73110	01	Board Certified* Radiologist or Orthopaedic Surgeon	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73115	03	Board Certified* Radiologist or Orthopaedic Surgeon	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73120	01	Board Certified* Radiologist or Orthopaedic Surgeon	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73130	01	Board Certified* Radiologist or Orthopaedic Surgeon	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73140	01	Board Certified* Radiologist or Orthopaedic Surgeon	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73200	01	Board Certified* Radiologist or Orthopaedic Surgeon	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
73201	02	Board Certified* Radiologist or Orthopaedic Surgeon	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
73202	02	Board Certified* Radiologist or Orthopaedic Surgeon	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
73206	02	Board Certified* Radiologist or Orthopaedic Surgeon	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
73218	01	Board Certified* Radiologist or Orthopaedic Surgeon	Credentialed by ARRT: MR or ARMRIT: MRI
73219	02	Board Certified* Radiologist or Orthopaedic Surgeon	Credentialed by ARRT: MR or ARMRIT: MRI
73220	02	Board Certified* Radiologist or Orthopaedic Surgeon	Credentialed by ARRT: MR or ARMRIT: MRI
73221	01	Board Certified* Radiologist or Orthopaedic Surgeon	Credentialed by ARRT: MR or ARMRIT: MRI
73222	02	Board Certified* Radiologist or Orthopaedic Surgeon	Credentialed by ARRT: MR or ARMRIT: MRI
73223	02	Board Certified* Radiologist or Orthopaedic Surgeon	Credentialed by ARRT: MR or ARMRIT: MRI
73225	02	Board Certified* Radiologist	Credentialed by ARRT: MR or ARMRIT: MRI
73501	01	Board Certified* Radiologist or Orthopaedic Surgeon	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73502	01	Board Certified* Radiologist or Orthopaedic Surgeon	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73503	01	Board Certified* Radiologist or Orthopaedic Surgeon	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73521	01	Board Certified* Radiologist or Orthopaedic Surgeon	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73522	01	Board Certified* Radiologist or Orthopaedic Surgeon	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73523	01	Board Certified* Radiologist or Orthopaedic Surgeon	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73525	03	Board Certified* Radiologist or Orthopaedic Surgeon	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73551	01	Board Certified* Radiologist or Orthopaedic Surgeon	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73552	01	Board Certified* Radiologist or Orthopaedic Surgeon	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73560	01	Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73562	09	Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73564	01	Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73565	01	Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73580	03	Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73590	01	Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73592	01	Board Certified* Radiologist or Orthopaedic Surgeon	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73600	01	Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73610	01	Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73615	03	Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73620	01	Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73630	01	Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73650	01	Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73660	01	Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
73700	01	Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
73701	02	Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
73702	02	Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
73706	02	Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
73718	01	Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist	Credentialed by ARRT: MR or ARMRIT: MRI
73719	02	Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist	Credentialed by ARRT: MR or ARMRIT: MRI
73720	02	Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist	Credentialed by ARRT: MR or ARMRIT: MRI
73721	01	Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist	Credentialed by ARRT: MR or ARMRIT: MRI
73722	02	Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist	Credentialed by ARRT: MR or ARMRIT: MRI
73723	02	Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist	Credentialed by ARRT: MR or ARMRIT: MRI
73725	02	Board Certified* Radiologist, Orthopaedic Surgeon or Podiatrist	Credentialed by ARRT: MR or ARMRIT: MRI
74018	01	Board Certified* Radiologist or Urologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
74019	01	Board Certified* Radiologist or Urologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
74021	01	Board Certified* Radiologist or Urologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
74022	01	Board Certified* Radiologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
74150	01	Board Certified* Radiologist or Urologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
74160	02	Board Certified* Radiologist or Urologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
74170	02	Board Certified* Radiologist or Urologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
74174	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
74175	02	Board Certified* Radiologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
74176	01	Board Certified* Radiologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
74177	02	Board Certified* Radiologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
74178	02	Board Certified* Radiologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
74181	01	Board Certified* Radiologist	Credentialed by ARRT: MR or ARMRIT: MRI
74182	02	Board Certified* Radiologist	Credentialed by ARRT: MR or ARMRIT: MRI
74183	02	Board Certified* Radiologist	Credentialed by ARRT: MR or ARMRIT: MRI
74185	02	Board Certified* Radiologist	Credentialed by ARRT: MR or ARMRIT: MRI
74190	03	Board Certified* Radiologist	Credentialed by ARRT: MR or ARMRIT: MRI
74210	03	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
74220	03	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
74221	03	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
74230	03	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
74240	03	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
74246	03	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
74248	03	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
74250	02	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
74251	03	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
74261	02	Board Certified* Gastroenterologist or Radiologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
74262	02	Board Certified* Gastroenterologist or Radiologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
74270	03	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
74280	03	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
74290	01	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
74300	03	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
74301	03	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
74328	03	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
74329	03	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
74330	03	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
74400	02	Board Certified* Radiologist or Urologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
74410	02	Board Certified* Radiologist or Urologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
74415	02	Board Certified* Radiologist or Urologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
74420	03	Board Certified* Radiologist or Urologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
74425	03	Board Certified* Radiologist or Urologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
74430	03	Board Certified* Radiologist or Urologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
74440	03	Board Certified* Radiologist or Urologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
74445	03	Board Certified* Radiologist or Urologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
74450	03	Board Certified* Radiologist or Urologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
74455	03	Board Certified* Radiologist or Urologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
74470	03	Board Certified* Radiologist or Urologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
74712	02	Board Certified* Radiologist or Gynecologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
74713	02	Board Certified* Radiologist or Gynecologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
74740	03	Board Certified* Radiologist or Gynecologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
74742	03	Board Certified* Radiologist or Gynecologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
74775	03	Board Certified* Radiologist or Gynecologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75557	01	Board Certified* Radiologist	Credentialed by ARRT: MR or ARMRIT: MRI
75559	02	Board Certified* Radiologist	Credentialed by ARRT: MR or ARMRIT: MRI
75561	01	Board Certified* Radiologist	Credentialed by ARRT: MR or ARMRIT: MRI
75563	01	Board Certified* Radiologist	Credentialed by ARRT: MR or ARMRIT: MRI
75565	01	Board Certified* Radiologist	Credentialed by ARRT: MR or ARMRIT: MRI
75571	09	Board Certified* Cardiologist or Radiologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
75572	02	Board Certified* Cardiologist or Radiologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
75573	02	Board Certified* Cardiologist or Radiologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
75574	02	Board Certified* Cardiologist or Radiologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
75580	01	Board Certified* Cardiologist or Radiologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
75600	03	Board Certified* Radiologist or Vascular Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75605	03	Board Certified* Radiologist or Vascular Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75625	03	Board Certified* Radiologist or Vascular Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75630	03	Board Certified* Radiologist or Vascular Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75635	02	Board Certified* Radiologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
75705	03	Board Certified* Radiologist, Vascular Surgeon or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75710	03	Board Certified* Radiologist, Cardiologist or Vascular Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75716	03	Board Certified* Radiologist, Cardiologist or Vascular Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75726	03	Board Certified* Radiologist or Vascular Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75731	03	Board Certified* Radiologist or Vascular Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75733	03	Board Certified* Radiologist or Vascular Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75736	03	Board Certified* Radiologist or Vascular Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75741	03	Board Certified* Radiologist or Vascular Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75743	03	Board Certified* Radiologist or Vascular Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75746	03	Board Certified* Radiologist or Vascular Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75756	03	Board Certified* Radiologist or Vascular Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75774	03	Board Certified* Radiologist, Vascular Surgeon or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75801	03	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75803	03	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75805	03	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75807	03	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75809	03	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75810	03	Board Certified* Radiologist or Vascular Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75820	03	Board Certified* Radiologist or Vascular Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75822	03	Board Certified* Radiologist or Vascular Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75825	03	Board Certified* Radiologist or Vascular Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75827	03	Board Certified* Radiologist or Vascular Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75831	03	Board Certified* Radiologist or Vascular Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75833	03	Board Certified* Radiologist or Vascular Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75840	03	Board Certified* Radiologist or Vascular Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75842	03	Board Certified* Radiologist or Vascular Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75860	03	Board Certified* Radiologist, Vascular Surgeon or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75870	03	Board Certified* Radiologist, Vascular Surgeon or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75872	03	Board Certified* Radiologist, Vascular Surgeon or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75880	03	Board Certified* Radiologist, Vascular Surgeon or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75885	03	Board Certified* Radiologist or Vascular Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75887	03	Board Certified* Radiologist or Vascular Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75889	03	Board Certified* Radiologist or Vascular Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R
75891	03	Board Certified* Radiologist or Vascular Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R
76000	03	Board Certified* Radiologist or Urologist or in the field related to the Primary Procedure	State License: General Radiographer or Credentialed by ARRT: R.T.-R
76010	01	Board Certified* Radiologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
76080	03	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Credentialed by ARRT: R.T.-R
76098	01	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
76100	01	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
76120	02	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
76125	02	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
76376	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT or ARRT: MR or ARMRIT: MRI or ARDMS: RDMS or ARRT: R.T.-S (as applicable)
76377	03	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT or ARRT: MR or ARMRIT: MRI or ARDMS: RDMS or ARRT: R.T.-S (as applicable)
76380	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
76390	01	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: MR or ARMRIT: MRI
76391	02	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: MR or ARMRIT: MRI
76506	01	Board Certified* Radiologist or Neurologist	Credentialed by ARDMS: RDMS-NE or ARRT: R.T.-S
76510	02	Board Certified* Ophthalmologist, Radiologist or Optometrist	Credentialed by ARDMS: RDMS-OP or JCAHPO: COT or COMT
76511	02	Board Certified* Ophthalmologist, Radiologist or Optometrist	Credentialed by ARDMS: RDMS-OP or JCAHPO: COT or COMT
76512	02	Board Certified* Ophthalmologist, Radiologist or Optometrist	Credentialed by ARDMS: RDMS-OP or JCAHPO: COT or COMT
76513	02	Board Certified* Ophthalmologist, Radiologist or Optometrist	Credentialed by ARDMS: RDMS-OP or JCAHPO: COT or COMT
76514	01	Board Certified* Ophthalmologist, Radiologist or Optometrist	Credentialed by ARDMS: RDMS-OP or JCAHPO: COT or COMT
76516	01	Board Certified* Ophthalmologist, Radiologist or Optometrist	Credentialed by ARDMS: ROUB or RDMS-OP or JCAHPO: COT or COMT
76519	01	Board Certified* Ophthalmologist, Radiologist or Optometrist	Credentialed by ARDMS: ROUB or RDMS- OP or JCAHPO: COT or COMT
76529	01	Board Certified* Ophthalmologist or Radiologist	Credentialed by ARDMS: ROUB or RDMS- OP or JCAHPO: COT or COMT
76536	01	Board Certified* Radiologist or Neurologist	Credentialed by ARDMS: RDMS or ARRT: R.T.-S
76604	01	Board Certified* Radiologist	Credentialed by ARDMS: RDMS or ARRT: R.T.-S
76641	01	Board Certified* Radiologist	Credentialed by ARDMS: RDMS or ARRT: R.T.-S
76642	01	Board Certified* Radiologist	Credentialed by ARDMS: RDMS or ARRT: R.T.-S
76700	01	Board Certified* Radiologist or Urologist	Credentialed by ARDMS: RDMS or ARRT: R.T.-S
76705	01	Board Certified* Radiologist or Urologist	Credentialed by ARDMS: RDMS or ARRT: R.T.-S
76706	09	Board Certified* Cardiologist or Radiologist	Credentialed by ARDMS: RVT or RDMS or ARRT: R.T.-S or R.T.-VS or CCI: RVS
76770	01	Board Certified* Radiologist or Urologist	Credentialed by ARDMS: RDMS or ARRT: R.T.-S
76775	01	Board Certified* Radiologist or Urologist	Credentialed by ARDMS: RDMS or ARRT: R.T.-S
76776	01	Board Certified* Radiologist or Urologist	Credentialed by ARDMS: RDMS or ARRT: R.T.-S
76801	01	Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine	Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S
76802	01	Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine	Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S
76805	01	Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine	Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S
76810	01	Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine	Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S
76811	01	Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine	Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S
76812	01	Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine	Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S
76813	01	Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine	Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S
76814	01	Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine	Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S
76815	01	Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine	Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S
76816	01	Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine	Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S
76817	01	Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine	Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S
76818	01	Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine	Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S
76819	01	Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine	Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S
76820	01	Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine	Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S
76821	01	Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine	Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S
76825	01	Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine	Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S
76826	01	Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine	Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S
76827	01	Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine	Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S
76828	01	Board Certified* Radiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine	Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S
76830	01	Board Certified* Radiologist, Urologist or Obstetrics/Gynecologist	Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S
76831	03	Board Certified* Radiologist	Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S
76856	01	Board Certified* Radiologist, Urologist or Obstetrics/Gynecologist	Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S
76857	01	Board Certified* Radiologist, Urologist or Obstetrics/Gynecologist	Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S
76870	01	Board Certified* Radiologist or Urologist	Credentialed by ARDMS: RDMS or ARRT: R.T.-S
76872	01	Board Certified* Radiologist or Urologist	Credentialed by ARDMS: RDMS or ARRT: R.T.-S
76873	02	Board Certified* Radiologist or Urologist	Credentialed by ARDMS: RDMS or ARRT: R.T.-S
76881	09	Board Certified* Radiologist or Podiatrist	Credentialed by ARDMS: RDMS or ARRT: R.T.-S
76882	09	Board Certified* Radiologist or Podiatrist	Credentialed by ARDMS: RDMS or ARRT: R.T.-S
76883	09	Board Certified* Radiologist or Podiatrist	Credentialed by ARDMS: RDMS or ARRT: R.T.-S
76885	01	Board Certified* Radiologist	Credentialed by ARDMS: RDMS or ARRT: R.T.-S
76886	01	Board Certified* Radiologist	Credentialed by ARDMS: RDMS or ARRT: R.T.-S
76942	03	Board Certified* Radiologist, Podiatrist, or Urologist	Credentialed by ARDMS: RDMS or ARRT: R.T.-S
76946	03	Board Certified* Radiologist	Credentialed by ARDMS: RDMS-OB/GYN or ARRT: R.T.-S
76975	03	Board Certified* Radiologist	Credentialed by ARDMS: RDMS or ARRT: R.T.-S
76977	01	Board Certified* Radiologist, Podiatrist or Urologist	Credentialed by ARDMS: RDMS or ARRT: R.T.-S or -BD
76978	03	Board Certified* Radiologist	Credentialed by ARDMS: RDMS or ARRT: R.T.-S
76979	03	Board Certified* Radiologist	Credentialed by ARDMS: RDMS or ARRT: R.T.-S
76981	01	Board Certified* Radiologist	Credentialed by ARDMS: RDMS or ARRT: R.T.-S
76982	01	Board Certified* Radiologist	Credentialed by ARDMS: RDMS or ARRT: R.T.-S
76983	01	Board Certified* Radiologist	Credentialed by ARDMS: RDMS or ARRT: R.T.-S
77002	03	Board Certified* Radiologist or in the field related to the Primary Procedure	State License: General Radiographer or Credentialed by ARRT: R.T.-R
77003	03	Board Certified* Radiologist or in the field related to the Primary Procedure	State License: General Radiographer or Credentialed by ARRT: R.T.-R
77012	03	Board Certified* Radiologist, Podiatrist or Urologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
77014	02	Board Certified* Radiologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
77021	03	Board Certified* Radiologist or Podiatrist	Credentialed by ARRT: MR or ARMRIT: MRI
77046	02	Board Certified* Radiologist	Credentialed by ARRT: MR or ARMRIT: MRI
77047	02	Board Certified* Radiologist	Credentialed by ARRT: MR or ARMRIT: MRI
77048	02	Board Certified* Radiologist	Credentialed by ARRT: MR or ARMRIT: MRI
77049	02	Board Certified* Radiologist	Credentialed by ARRT: MR or ARMRIT: MRI
77053	03	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-M
77054	03	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-M
77063	09	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-M
77065	09	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-M
77066	09	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-M
77067	09	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-M
77071	03	Board Certified* Radiologist or Podiatrist	Physician Service Code – Must be performed by a physician
77072	01	Board Certified* Radiologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
77073	01	Board Certified* Radiologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
77074	01	Board Certified* Radiologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
77075	01	Board Certified* Radiologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
77076	01	Board Certified* Radiologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
77077	01	Board Certified* Radiologist or Podiatrist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
77078	01	Board Certified* Radiologist or Urologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
77080	01	Board Certified* Radiologist, Internal Medicine Specialist, Urologist or Orthopaedic Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-BD or ISCD: CBDT
77081	01	Board Certified* Radiologist, Internal Medicine Specialist, Urologist or Orthopaedic Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-BD or ISCD: CBDT
77084	01	Board Certified* Radiologist	Credentialed by ARRT: MR or ARMRIT: MRI
77085	01	Board Certified* Radiologist, Internal Medicine Specialist, Urologist or Orthopaedic Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-BD or ISCD: CBDT
77086	01	Board Certified* Radiologist, Internal Medicine Specialist, Urologist or Orthopaedic Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-BD or ISCD: CBDT
77417	01	Board Certified* Radiologist	State License: General Radiographer or Medical Physicist or Credentialed by ARRT: R.T.-R
78012	09	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78013	09	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78014	09	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78015	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78016	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78018	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78020	09	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78070	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78071	09	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78072	09	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78075	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78102	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78103	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78104	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78110	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78111	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78120	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78121	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78122	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78130	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78140	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78185	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78191	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78195	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78201	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78202	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78215	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78216	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78226	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78227	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78230	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78231	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78232	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78258	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78261	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78262	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78264	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78265	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78266	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78267	09	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78268	09	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78278	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78282	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78290	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78291	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78300	01	Board Certified* Nuclear Medicine, Radiology or Podiatrist	Credentialed by ARRT: N or NMTCB: CNMT
78305	01	Board Certified* Nuclear Medicine, Radiology or Podiatrist	Credentialed by ARRT: N or NMTCB: CNMT
78306	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78315	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78350	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78414	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78428	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78429	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78430	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78431	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78432	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78433	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78434	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78445	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78451	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78452	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78453	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78454	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78456	09	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78457	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78458	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78459	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78466	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78468	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78469	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78472	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78473	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78481	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78483	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78491	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78492	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78494	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78496	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78579	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78580	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78582	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or MTCB: CNMT
78597	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78598	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78600	01	Board Certified* Nuclear Medicine, Radiology or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: N or NMTCB: CNMT
78601	01	Board Certified* Nuclear Medicine, Radiology or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: N or NMTCB: CNMT
78605	01	Board Certified* Nuclear Medicine, Radiology or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: N or NMTCB: CNMT
78606	01	Board Certified* Nuclear Medicine, Radiology or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: N or NMTCB: CNMT
78608	01	Board Certified* Nuclear Medicine, Radiology or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: N or NMTCB: CNMT
78610	01	Board Certified* Nuclear Medicine, Radiology or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: N or NMTCB: CNMT
78630	01	Board Certified* Nuclear Medicine, Radiology or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: N or NMTCB: CNMT
78635	01	Board Certified* Nuclear Medicine, Radiology or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: N or NMTCB: CNMT
78645	01	Board Certified* Nuclear Medicine, Radiology or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: N or NMTCB: CNMT
78650	01	Board Certified* Nuclear Medicine, Radiology or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: N or NMTCB: CNMT
78660	01	Board Certified* Nuclear Medicine, Radiology or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: N or NMTCB: CNMT
78700	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78701	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78707	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78708	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78709	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78725	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78730	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78740	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78761	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78800	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78801	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78802	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78803	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78804	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78811	01	Board Certified* Nuclear Medicine, Radiology or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: N or NMTCB: CNMT
78812	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78813	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78814	01	Board Certified* Nuclear Medicine, Radiology or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: N or NMTCB: CNMT
78815	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78816	01	Board Certified* Nuclear Medicine or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78830	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78831	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78832	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
78835	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
86485	09	Board Certified* M.D. or D.O.	Licensed Personnel
86490	09	Board Certified* M.D. or D.O.	Licensed Personnel
86580	09	Board Certified* M.D. or D.O.	Licensed Personnel
91010	02	Board Certified* Gastroenterologist	RN
91020	02	Board Certified* Gastroenterologist	RN
91022	02	Board Certified* Gastroenterologist	RN
91030	02	Board Certified* Gastroenterologist	RN
91034	02	Board Certified* Gastroenterologist	RN
91035	02	Board Certified* Gastroenterologist	RN
91037	02	Board Certified* Gastroenterologist	RN
91038	02	Board Certified* Gastroenterologist	RN
91040	02	Board Certified* Gastroenterologist	RN
91065	09	Board Certified* Gastroenterologist	RN
91110	09	Board Certified* Gastroenterologist	RN
91111	09	Board Certified* Gastroenterologist	RN
91113	09	Board Certified* Gastroenterologist	RN
91120	02	Board Certified* Gastroenterologist Colorectal Surgeon	RN
91122	02	Board Certified* Gastroenterologist Colorectal Surgeon	RN
91132	01	Board Certified* Gastroenterologist	RN
91133	03	Board Certified* Gastroenterologist	RN
92025	09	Board Certified* Ophthalmologist, Neurologist or Optometrist	Credentialed by JCAHPO: COT or COMT
92060	01	Board Certified* Ophthalmologist, Neurologist or Optometrist	Credentialed by JCAHPO: COT or COMT
92081	01	Board Certified* Ophthalmologist, Neurologist or Optometrist	Credentialed by JCAHPO: COT or COMT
92082	01	Board Certified* Ophthalmologist, Neurologist or Optometrist	Credentialed by JCAHPO: COT or COMT
92083	01	Board Certified* Ophthalmologist, Neurologist or Optometrist	Credentialed by JCAHPO: COT or COMT
92100	09	Board Certified* Ophthalmologist or Optometrist	Physician Service Code – Must be performed by a physician
92132	01	Board Certified* Ophthalmologist or Optometrist	Credentialed by JCAHPO: COT or COMT
92133	01	Board Certified* Ophthalmologist or Optometrist	Credentialed by JCAHPO: COT or COMT
92134	01	Board Certified* Ophthalmologist or Optometrist	Credentialed by JCAHPO: COT or COMT
92136	09	Board Certified* Ophthalmologist or Optometrist	Credentialed by JCAHPO: COT or COMT
92229	09	Board Certified* Ophthalmologist or Optometrist	Credentialed by JCAHPO: COT or COMT
92230	09	Board Certified* Ophthalmologist, Neurologist or Optometrist	Credentialed by JCAHPO: COT or COMT
92235	02	Board Certified* Ophthalmologist, Neurologist or Optometrist	Credentialed by JCAHPO: COT or COMT
92240	02	Board Certified* Ophthalmologist, Neurologist or Optometrist	Credentialed by JCAHPO: COT or COMT
92242	02	Board Certified* Ophthalmologist, Neurologist or Optometrist	Credentialed by JCAHPO: COT or COMT
92250	01	Board Certified* Ophthalmologist, Neurologist or Optometrist	Credentialed by JCAHPO: COT or COMT
92265	03	Board Certified* Ophthalmologist, Neurologist, Physiatrist or Optometrist	Credentialed by JCAHPO: COT or COMT
92270	01	Board Certified* Ophthalmologist, Neurologist or Optometrist	Credentialed by JCAHPO: COT or COMT
92273	01	Board Certified* Ophthalmologist, Neurologist or Optometrist	Credentialed by JCAHPO: COT or COMT
92274	01	Board Certified* Ophthalmologist, Neurologist or Optometrist	Credentialed by JCAHPO: COT or COMT
92283	01	Board Certified* Ophthalmologist, Neurologist or Optometrist	Credentialed by JCAHPO: COT or COMT
92284	01	Board Certified* Ophthalmologist, Neurologist or Optometrist	Credentialed by JCAHPO: COT or COMT
92285	01	Board Certified* Ophthalmologist, Neurologist or Optometrist	Credentialed by JCAHPO: COT or COMT
92286	01	Board Certified* Ophthalmologist, Neurologist or Optometrist	Credentialed by JCAHPO: COT or COMT or OPS: CRA
92511	03	Board Certified* Otolaryngologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
92517	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92518	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92519	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92537	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92538	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92540	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92541	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92542	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92544	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92545	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92546	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92547	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92548	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92549	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92550	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92552	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92553	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92555	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92556	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92557	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92562	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92563	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92565	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92567	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92568	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92570	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92571	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92572	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92575	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92576	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92577	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92579	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92582	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92583	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92584	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92587	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92588	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92596	09	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92597	09	Board Certified* Neurologist or Otolaryngologist	Physician service code – must be performed by a physician
92601	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92602	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92603	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92604	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92611	09	Board Certified* Radiologist or Otolaryngologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
92620	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92621	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92625	02	Board Certified* Neurologist or Otolaryngologist	Licensed Audiologist*
92651	02	Board Certified* Neurologist, Physiatrist or Otolaryngologist	Licensed Audiologist*
92652	02	Board Certified* Neurologist, Physiatrist or Otolaryngologist	Licensed Audiologist*
92653	02	Board Certified* Neurologist, Physiatrist or Otolaryngologist	Licensed Audiologist*
93000	01	Board Certified* Internist or Cardiologist	RN, Licensed Practical Nurse (LPN)/Licensed Vocational Nurse (LVN), or State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
93005	01	Board Certified* Internist or Cardiologist	RN, LPN/LVN, or State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
93010	09	Board Certified* Internist or Cardiologist	Professional component only code – must be performed by a physician
93015	02	Board Certified* Internist, Cardiologist or Nuclear Medicine – ACLS Certified	RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET or ARRT: R.T.-N or NMTCB: CNMT
93016	02	Board Certified* Internist, Cardiologist or Nuclear Medicine – ACLS Certified	RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET or ARRT: R.T.-N or NMTCB: CNMT
93017	02	Board Certified* Internist, Cardiologist or Nuclear Medicine – ACLS Certified	RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET or ARRT: R.T.-N or NMTCB: CNMT
93018	09	Board Certified* Cardiologist or Nuclear Medicine	Professional component only code – must be performed by a physician
93024	03	Board Certified* Internist or Cardiologist – ACLS Certified	RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
93025	01	Board Certified* Internist or Cardiologist – ACLS Certified	RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
93040	01	Board Certified* Internist or Cardiologist	RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
93041	01	Board Certified* Internist or Cardiologist	RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
93042	09	Board Certified* Cardiologist	Professional Component Code – must be performed by a physician
93224	01	Board Certified* Cardiologist	RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
93225	01	Board Certified* Cardiologist	RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
93226	01	Board Certified* Cardiologist	RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
93227	09	Board Certified* Cardiologist	Professional Component Only Code – must be performed by a physician
93228	09	Board Certified* Cardiologist	Professional Component Only Code – service must be performed by a physician
93229	01	Board Certified* Cardiologist	State Licensed: RN or Paramedic or Credentialed by NHA: CET or CCI: CCT or CRAT
93241	01	Board Certified* Cardiologist	RN, State Licensed Paramedic or Credentialed by CCI: CCT or CRAT or NHA: CET
93242	01	Board Certified* Cardiologist	RN, State Licensed Paramedic or Credentialed by CCI: CCT or CRAT or NHA: CET
93243	01	Board Certified* Cardiologist	RN, State Licensed Paramedic or Credentialed by CCI: CCT or CRAT or NHA: CET
93244	09	Board Certified* Cardiologist	Professional Component Only Code – must be performed by a physician
93245	01	Board Certified* Cardiologist	RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
93246	01	Board Certified* Cardiologist	RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
93247	01	Board Certified* Cardiologist	RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
93248	09	Board Certified* Cardiologist	Professional Component Only Code – must be performed by a physician
93260	02	Board Certified* Cardiologist	RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
93261	02	Board Certified* Cardiologist	RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
93268	01	Board Certified* Cardiologist	RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
93270	01	Board Certified* Cardiologist	RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
93271	01	Board Certified* Cardiologist	RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
93272	09	Board Certified* Cardiologist	Professional Component Only Code – must be performed by a physician
93278	01	Board Certified* Cardiologist	RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
93279	02	Board Certified* Cardiologist	RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
93280	02	Board Certified* Cardiologist	RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
93281	02	Board Certified* Cardiologist	RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
93282	02	Board Certified* Cardiologist	RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
93283	02	Board Certified* Cardiologist	RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
93284	02	Board Certified* Cardiologist	RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
93285	02	Board Certified* Cardiologist	RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
93286	02	Board Certified* Cardiologist	RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
93287	02	Board Certified* Cardiologist	RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
93288	02	Board Certified* Cardiologist	RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
93289	02	Board Certified* Cardiologist	RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
93290	02	Board Certified* Cardiologist	RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
93291	02	Board Certified* Cardiologist	RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
93292	02	Board Certified* Cardiologist	RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
93293	01	Board Certified* Cardiologist	RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
93294	09	Board Certified* Cardiologist	Professional Component Only Code – service must be performed by a physician
93295	09	Board Certified* Cardiologist	Professional Component Only Code – service must be performed by a physician
93296	01	Board Certified* Cardiologist	RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
93297	01	Board Certified* Cardiologist	State Licensed RN or Paramedic or Credentialed by CCI: CCT or CRAT or NHA: CET
93298	01	Board Certified* Cardiologist	State Licensed RN or Paramedic or Credentialed by CCI: CCT or CRAT or NHA: CET
93303	01	Board Certified* Cardiologist	Credentialed by ARDMS: RDCS or CCI: RCS
93304	01	Board Certified* Cardiologist	Credentialed by ARDMS: RDCS or CCI: RCS
93306	01	Board Certified* Cardiologist	Credentialed by ARDMS: RDCS or CCI: RCS
93307	01	Board Certified* Cardiologist	Credentialed by ARDMS: RDCS or CCI: RCS
93308	01	Board Certified* Cardiologist	Credentialed by ARDMS: RDCS or CCI: RCS
93312	03	Board Certified* Cardiologist	Credentialed by ARDMS: RDCS or CCI: RCS
93313	03	Board Certified* Cardiologist	Physician Service Code – must be performed by a physician
93314	03	Board Certified* Cardiologist	Credentialed by ARDMS: RDCS or CCI: RCS
93315	03	Board Certified* Cardiologist	Credentialed by ARDMS: RDCS or CCI: RCS
93316	03	Board Certified* Cardiologist	Physician Service Code – must be performed by a physician
93317	03	Board Certified* Cardiologist	Credentialed by ARDMS: RDCS or CCI: RCS
93319	09	Board Certified* Cardiologist	Credentialed by ARDMS: RDCS or CCI: RCS
93320	01	Board Certified* Cardiologist	Credentialed by ARDMS: RDCS or CCI: RCS
93321	01	Board Certified* Cardiologist	Credentialed by ARDMS: RDCS or CCI: RCS
93325	01	Board Certified* Cardiologist or Obstetrics/Gynecologist with Subspecialty Certification in Maternal Fetal Medicine	Credentialed by ARDMS: RDCS or CCI: RCS
93350	02	Board Certified* Cardiologist	RN or State Licensed Paramedic or Credentialed by ARDMS: RDCS or CCI: RCS
93351	02	Board Certified* Cardiologist	State Licensed RN or Paramedic, or Credentialed by ARDMS: RDCS or CCI: RCS
93352	09	Board Certified* Cardiologist	Physician Service Code – service must be performed by a physician
93451	03	Board Certified* Cardiologist with Level 02 Training (minimum) as outlined by the ACC/AHA Task Force 3	Credentialed by: ARRT: CI or CCI: RCIS
93452	03	Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3	Credentialed by: ARRT: CI or CCI: RCIS
93453	03	Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3	Credentialed by: ARRT: CI or CCI: RCIS
93454	03	Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3	Credentialed by: ARRT: CI or CCI: RCIS
93455	03	Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3	Credentialed by: ARRT: CI or CCI: RCIS
93456	03	Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3	Credentialed by: ARRT: CI or CCI: RCIS
93457	03	Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3	Credentialed by: ARRT: CI or CCI: RCIS
93458	03	Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3	Credentialed by: ARRT: CI or CCI: RCIS
93459	03	Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3	Credentialed by: ARRT: CI or CCI: RCIS
93460	03	Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3	Credentialed by: ARRT: CI or CCI: RCIS
93461	03	Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3	Credentialed by: ARRT: CI or CCI: RCIS
93571	03	Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3	Credentialed by: ARRT: CI or CCI: RCIS
93572	03	Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3	Credentialed by: ARRT: CI or CCI: RCIS
93584	09	Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3	Credentialed by: ARRT: CI or CCI: RCIS
93585	09	Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3	Credentialed by: ARRT: CI or CCI: RCIS
93586	09	Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3	Credentialed by: ARRT: CI or CCI: RCIS
93587	09	Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3	Credentialed by: ARRT: CI or CCI: RCIS
93588	09	Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3	Credentialed by: ARRT: CI or CCI: RCIS
93593	03	Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3	Credentialed by: ARRT: CI or CCI: RCIS
93594	03	Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3	Credentialed by: ARRT: CI or CCI: RCIS
93595	03	Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3	Credentialed by: ARRT: CI or CCI: RCIS
93596	03	Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3	Credentialed by: ARRT: CI or CCI: RCIS
93597	03	Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3	Credentialed by: ARRT: CI or CCI: RCIS
93598	03	Board Certified* Cardiologist with Level 2 Training (minimum) as outlined by the ACC/AHA Task Force 3	Credentialed by: ARRT: CI or CCI: RCIS
93660	02	Board Certified* Cardiologist	Credentialed by NHA: CET or CCI: CCT, RCIS, RCS or ARDMS: RDCS or RN
93701	09	Board Certified* Cardiologist	Demonstrates Proficiency
93740	09	Board Certified* Cardiologist	Credentialed by CCI: CCT, NHA: CET, State licensed Paramedic or RN
93770	09	Board Certified* Cardiologist	Credentialed by CCI: CCT, NHA: CET, State Licensed Paramedic or RN
93784	01	Board Certified* Cardiologist, Internal Medicine or Family Practice	Credentialed by CCI: CCT, NHA: CET, State Licensed Paramedic or RN
93786	01	Board Certified* Cardiologist, Internal Medicine or Family Practice	Credentialed by CCI: CCT, NHA: CET, State Licensed Paramedic or RN
93788	09	Board Certified* Cardiologist, Internal Medicine or Family Practice	Credentialed by CCI: CCT, NHA: CET, State Licensed Paramedic or RN
93790	09	Board Certified* Cardiologist, Internal Medicine or Family Practice	Professional Component Only Code – must be performed by a physician
93792	01	Board Certified* Cardiologist	RN
93880	01	Board Certified* Radiologist, Neurologist, Cardiologist, Vascular Surgeon or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS
93882	01	Board Certified* Radiologist, Neurologist, Cardiologist, Vascular Surgeon or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS
93886	01	Board Certified* Radiologist, Neurologist, Cardiologist or Vascular Surgeon	Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS
93888	01	Board Certified* Radiologist, Neurologist, Cardiologist or Vascular Surgeon	Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS
93890	01	Board Certified* Radiologist, Neurologist, Cardiologist or Vascular Surgeon	Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS
93892	01	Board Certified* Radiologist, Neurologist, Cardiologist or Vascular Surgeon	Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS
93893	01	Board Certified* Radiologist, Neurologist, Cardiologist or Vascular Surgeon	Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS
93922	01	Board Certified* Radiologist, Cardiologist, Podiatrist or Vascular Surgeon	Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS
93923	01	Board Certified* Radiologist, Cardiologist, Podiatrist or Vascular Surgeon	Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS
93924	01	Board Certified* Radiologist, Cardiologist, Podiatrist or Vascular Surgeon	Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS
93925	01	Board Certified* Radiologist, Cardiologist, Podiatrist or Vascular Surgeon	Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS
93926	01	Board Certified* Radiologist, Cardiologist, Podiatrist or Vascular Surgeon	Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS
93930	01	Board Certified* Radiologist, Cardiologist or Vascular Surgeon	Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS
93931	01	Board Certified* Radiologist, Cardiologist or Vascular Surgeon	Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS
93970	01	Board Certified* Radiologist, Cardiologist or Vascular Surgeon	Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS
93971	01	Board Certified* Radiologist, Cardiologist or Vascular Surgeon	Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS
93975	01	Board Certified* Radiologist, Vascular Surgeon, Urologist or Obstetrics/Gynecologist	Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS
93976	01	Board Certified* Radiologist, Vascular Surgeon, Urologist or Obstetrics/Gynecologist	Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS
93978	01	Board Certified* Radiologist or Vascular Surgeon	Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS
93979	01	Board Certified* Radiologist or Vascular Surgeon	Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS
93980	01	Board Certified* Radiologist, Urologist or Vascular Surgeon	Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS
93981	01	Board Certified* Radiologist, Urologist or Vascular Surgeon	Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS
93985	01	Board Certified* Radiologist, Urologist or Vascular Surgeon	Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS
93986	01	Board Certified* Radiologist, Urologist or Vascular Surgeon	Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS
93990	01	Board Certified* Radiologist or Vascular Surgeon	Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS
94010	01	Board Certified* Pulmonologist	State License: Respiratory Therapist or RN
94014	01	Board Certified* Pulmonologist	State License: Respiratory Therapist or RN
94015	01	Board Certified* Pulmonologist	State License: Respiratory Therapist or RN
94016	09	Board Certified* Pulmonologist	Professional Component Only Code – must be performed by a physician
94060	02	Board Certified* Pulmonologist	State License: Respiratory Therapist or RN
94070	02	Board Certified* Pulmonologist	State License: Respiratory Therapist or RN
94150	01	Board Certified* Pulmonologist	State License: Respiratory Therapist
94200	01	Board Certified* Pulmonologist	State License: Respiratory Therapist
94375	01	Board Certified* Pulmonologist	State License: Respiratory Therapist
94450	02	Board Certified* Pulmonologist	State License: Respiratory Therapist
94452	02	Board Certified* Pulmonologist	State License: Respiratory Therapist or RN
94453	02	Board Certified* Pulmonologist	State License: Respiratory Therapist or RN
94617	01	Board Certified* Pulmonologist	State License: Respiratory Therapist or RN
94618	01	Board Certified* Pulmonologist	State License: Respiratory Therapist or RN
94619	01	Board Certified* Pulmonologist	State License: Respiratory Therapist or RN
94621	02	Board Certified* Pulmonologist	State License: Respiratory Therapist or RN
94664	02	Board Certified* Pulmonologist	State License: Respiratory Therapist or RN
94680	02	Board Certified* Pulmonologist	State License: Respiratory Therapist
94681	02	Board Certified* Pulmonologist	State License: Respiratory Therapist
94690	01	Board Certified* Pulmonologist	State License: Respiratory Therapist
94726	01	Board Certified* Pulmonologist	State License: Respiratory Therapist
94727	01	Board Certified* Pulmonologist	State License: Respiratory Therapist
94728	01	Board Certified* Pulmonologist	State License: Respiratory Therapist
94729	01	Board Certified* Pulmonologist	State License: Respiratory Therapist
94760	01	Board Certified* Pulmonologist	Demonstrates Proficiency
94761	01	Board Certified* Pulmonologist	Demonstrates Proficiency
94762	01	Board Certified* Pulmonologist	Demonstrates Proficiency
94772	01	Board Certified* Pulmonologist	State License: Respiratory Therapist
94774	09	Board Certified* Pulmonologist	Credentialed by NBRC: CRT, RRT, CPFT, or RPFT
94775	09	Board Certified* Pulmonologist	Credentialed by NBRC: CRT, RRT, CPFT, or RPFT
94776	09	Board Certified* Pulmonologist	Credentialed by NBRC: CRT, RRT, CPFT, or RPFT
94777	09	Board Certified* Pulmonologist	Credentialed by NBRC: CRT, RRT, CPFT, or RPFT
95004	02	Board Certified* Allergy, Asthma and Immunology or Otolaryngology	RN
95024	02	Board Certified* Allergy, Asthma and Immunology or Otolaryngology	RN
95027	02	Board Certified* Allergy, Asthma and Immunology or Otolaryngology	RN
95028	02	Board Certified* Otolaryngologist	RN
95044	02	Board Certified* Otolaryngologist	RN
95052	02	Board Certified* Otolaryngologist	RN
95056	02	Board Certified* Otolaryngologist	RN
95060	03	Board Certified* Otolaryngologist, Ophthalmologist or Optometrist	RN
95065	03	Board Certified* Otolaryngologist	RN
95070	02	Board Certified* Otolaryngologist	RN
95700	01	Board Certified* Neurologist	Credentialed by ABRET: R. EEG T
95705	01	Board Certified* Neurologist	Credentialed by ABRET: R. EEG T
95706	01	Board Certified* Neurologist	Credentialed by ABRET: R. EEG T
95707	01	Board Certified* Neurologist	Credentialed by ABRET: R. EEG T
95708	01	Board Certified* Neurologist	Credentialed by ABRET: R. EEG T
95709	01	Board Certified* Neurologist	Credentialed by ABRET: R. EEG T
95710	01	Board Certified* Neurologist	Credentialed by ABRET: R. EEG T
95711	01	Board Certified* Neurologist	Credentialed by ABRET: R. EEG T
95712	01	Board Certified* Neurologist	Credentialed by ABRET: R. EEG T
95713	01	Board Certified* Neurologist	Credentialed by ABRET: R. EEG T
95714	01	Board Certified* Neurologist	Credentialed by ABRET: R. EEG T
95715	01	Board Certified* Neurologist	Credentialed by ABRET: R. EEG T
95716	01	Board Certified* Neurologist	Credentialed by ABRET: R. EEG T
95717	09	Board Certified* Neurologist	Credentialed by ABRET: R. EEG T
95718	09	Board Certified* Neurologist	Credentialed by ABRET: R. EEG T
95719	09	Board Certified* Neurologist	Credentialed by ABRET: R. EEG T
95720	09	Board Certified* Neurologist	Credentialed by ABRET: R. EEG T
95721	09	Board Certified* Neurologist	Credentialed by ABRET: R. EEG T
95722	09	Board Certified* Neurologist	Credentialed by ABRET: R. EEG T
95723	09	Board Certified* Neurologist	Credentialed by ABRET: R. EEG T
95724	09	Board Certified* Neurologist	Credentialed by ABRET: R. EEG T
95725	09	Board Certified* Neurologist	Credentialed by ABRET: R. EEG T
95726	09	Board Certified* Neurologist	Credentialed by ABRET: R. EEG T
95782	01	Physician Certified by ABSM or ABMS: Sleep Medicine OR ABFM, ABIM, ABOHNS, ABPN or AOA: Sleep Medicine Subspecialty Certification	Credentialed by BRPT: RPSGT or CPSGT, ABRET: R. EEG T. (Polysomnography) or NBRC: CRT, SDS or RRT
95783	01	Physician Certified by ABSM or ABMS: Sleep Medicine OR ABFM, ABIM, ABOHNS, ABPN or AOA: Sleep Medicine Subspecialty Certification	Credentialed by BRPT: RPSGT or CPSGT, ABRET: R. EEG T. (Polysomnography) or NBRC: CRT, SDS or RRT
95800	09	Physician Certified by ABSM or ABMS: Sleep Medicine OR ABFM, ABIM, ABOHNS, ABPN or AOA: Sleep Medicine Subspecialty Certification	Credentialed by BRPT: RPSGT or CPSGT, ABRET: R. EEG T. (Polysomnography) or NBRC: CRT, SDS or RRT
95801	09	Physician Certified by ABSM or ABMS: Sleep Medicine OR ABFM, ABIM, ABOHNS, ABPN or AOA: Sleep Medicine Subspecialty Certification	Credentialed by BRPT: RPSGT or CPSGT, ABRET: R. EEG T. (Polysomnography) or NBRC: CRT, SDS or RRT
95805	01	Physician Certified by ABSM or ABMS: Sleep Medicine OR ABFM, ABIM, ABOHNS, ABPN, or AOA: Sleep Medicine Subspecialty Certification	Credentialed by BRPT: RPSGT or CPSGT, ABRET: R. EEG T. (Polysomnography) or NBRC: CRT, SDS or RRT
95806	01	Physician Certified by ABSM or ABMS: Sleep Medicine OR ABFM, ABIM, ABOHNS, ABPN or AOA: Sleep Medicine Subspecialty Certification	Credentialed by BRPT: RPSGT or CPSGT, ABRET: R. EEG T. (Polysomnography) or NBRC: CRT, SDS or RRT
95807	01	Physician Certified by ABSM or ABMS: Sleep Medicine OR ABFM, ABIM, ABOHNS, ABPN, or AOA: Sleep Medicine Subspecialty Certification	Credentialed by BRPT: RPSGT or CPSGT, ABRET: R. EEG T. (Polysomnography) or NBRC: CRT, SDS or RRT
95808	01	Physician Certified by ABSM or ABMS: Sleep Medicine OR ABFM, ABIM, ABOHNS, ABPN, or AOA: Sleep Medicine Subspecialty Certification	Credentialed by BRPT: RPSGT or CPSGT, ABRET: R. EEG T. (Polysomnography) or NBRC: CRT, SDS or RRT
95810	01	Physician Certified by ABSM or ABMS: Sleep Medicine OR ABFM, ABIM, ABOHNS, ABPN, or AOA: Sleep Medicine Subspecialty Certification	Credentialed by BRPT: RPSGT or CPSGT, ABRET: R. EEG T. (Polysomnography) or NBRC: CRT, SDS or RRT
95811	01	Physician Certified by ABSM or ABMS: Sleep Medicine OR ABFM, ABIM, ABOHNS, ABPN, or AOA: Sleep Medicine Subspecialty Certification	Credentialed by BRPT: RPSGT or CPSGT, ABRET: R. EEG T. (Polysomnography) or NBRC: CRT, SDS or RRT
95812	01	Board Certified* Neurologist	Credentialed by ABRET: R. EEG T
95813	01	Board Certified* Neurologist	Credentialed by ABRET: R. EEG T
95816	09	Board Certified* Neurologist	Credentialed by ABRET: R. EEG T
95819	09	Board Certified* Neurologist	Credentialed by ABRET: R. EEG T
95822	09	Board Certified* Neurologist	Credentialed by ABRET: R. EEG T
95824	01	Board Certified* Neurologist	Credentialed by ABRET: R. EEG T
95830	09	Board Certified* Neurologist	Physician Service Code – must be performed by a physician
95860	6A	Board Certified* Neurologist or Physical Medicine and Rehabilitation (PMR) Physician with additional certification by: a) American Board of Electrodiagnostic Medicine, b) Clinical Neurophysiology, or c) American Board of Neurophysiology; or a Physical Therapist who is certified by the American Board of Physical Therapy Specialties (ABPTS) as a qualified clinical electrophysiology specialist and is permitted to provide the service under state law.	Procedure must be personally performed by a qualified physician who may or may not be the supervising physician. The qualified performing physician when assisted must provide personal supervision during the performance of EMG test(s) to the IDTF technician providing assistance. In addition, EMG procedures may be personally performed by a Physical Therapist (PT) with ABPTS certification and certification in this specific procedure. The following are considered appropriate credentials to assist a physician performing an EMG: AAET: R. NCS.T, ABEM: CNCT or State Licensed Physical Therapist with ABPTS certification.
95861	6A	Board Certified* Neurologist; or Physical Medicine and Rehabilitation (PMR) Physician with additional certification by: a) American Board of Electrodiagnostic Medicine, b) Clinical Neurophysiology, or c) American Board of Neurophysiology; or a Physical Therapist who is certified by the American Board of Physical Therapy Specialties (ABPTS) as a qualified electrophysiologic clinical specialist and is permitted to provide the service under state law.	Procedure must be personally performed by a qualified physician who may or may not be the supervising physician. The qualified performing physician when assisted must provide personal supervision during the performance of EMG test(s) to the IDTF technician providing assistance. In addition, EMG procedures may be personally performed by a Physical Therapist (PT) with ABPTS certification and certification in this specific procedure. The following are considered appropriate credentials to assist a physician performing an EMG: AAET: R. NCS.T, ABEM: CNCT or State Licensed Physical Therapist with ABPTS certification.
95863	6A	Board Certified* Neurologist; or Physical Medicine and Rehabilitation (PMR) Physician with additional certification by: a) American Board of Electrodiagnostic Medicine, b) Clinical Neurophysiology, or c) American Board of Neurophysiology; or a Physical Therapist who is certified by the American Board of Physical Therapy Specialties (ABPTS) as a qualified clinical electrophysiology specialist and is permitted to provide the service under state law.	Procedure must be personally performed by a qualified physician who may or may not be the supervising physician. The qualified performing physician when assisted must provide personal supervision during the performance of EMG test(s) to the IDTF technician providing assistance. In addition, EMG procedures may be personally performed by a Physical Therapist (PT) with ABPTS certification and certification in this specific procedure. The following are considered appropriate credentials to assist a physician performing an EMG: AAET: R. NCS.T, ABEM: CNCT or State Licensed Physical Therapist with ABPTS certification.
95864	6A	Board Certified* Neurologist; or Physical Medicine and Rehabilitation (PMR) Physician with additional certification by: a) American Board of Electrodiagnostic Medicine, b) Clinical Neurophysiology, or c) American Board of Neurophysiology; or a Physical Therapist who is certified by the American Board of Physical Therapy Specialties (ABPTS) as a qualified clinical electrophysiology specialist and is permitted to provide the service under state law.	Procedure must be personally performed by a qualified physician who may or may not be the supervising physician. The qualified performing physician when assisted must provide personal supervision during the performance of EMG test(s) to the IDTF technician providing assistance. In addition, EMG procedures may be personally performed by a Physical Therapist (PT) with ABPTS certification and certification in this specific procedure. The following are considered appropriate credentials to assist a physician performing an EMG: AAET: R. NCS.T, ABEM: CNCT or State Licensed Physical Therapist with ABPTS certification.
95867	6A	Board Certified* Neurologist; or Physical Medicine and Rehabilitation (PMR) Physician with additional certification by: a) American Board of Electrodiagnostic Medicine, b) Clinical Neurophysiology, or c) American Board of Neurophysiology; or a Physical Therapist who is certified by the American Board of Physical Therapy Specialties (ABPTS) as a qualified clinical electrophysiology specialist and is permitted to provide the service under state law.	Procedure must be personally performed by a qualified physician who may or may not be the supervising physician. The qualified performing physician when assisted must provide personal supervision during the performance of EMG test(s) to the IDTF technician providing assistance. In addition, EMG procedures may be personally performed by a Physical Therapist (PT) with ABPTS certification and certification in this specific procedure. The following are considered appropriate credentials to assist a physician performing an EMG: AAET: R. NCS.T, ABEM: CNCT or State Licensed Physical Therapist with ABPTS certification.
95868	6A	Board Certified* Neurologist; or Physical Medicine and Rehabilitation (PMR) Physician with additional certification by: a) American Board of Electrodiagnostic Medicine, b) Clinical Neurophysiology, or c) American Board of Neurophysiology; or a Physical Therapist who is certified by the American Board of Physical Therapy Specialties (ABPTS) as a qualified clinical electrophysiology specialist and is permitted to provide the service under state law.	Procedure must be personally performed by a qualified physician who may or may not be the supervising physician. The qualified performing physician when assisted must provide personal supervision during the performance of EMG test(s) to the IDTF technician providing assistance. In addition, EMG procedures may be personally performed by a Physical Therapist (PT) with ABPTS certification and certification in this specific procedure. The following are considered appropriate credentials to assist a physician performing an EMG: AAET: R. NCS.T, ABEM: CNCT or State Licensed Physical Therapist with ABPTS certification.
95869	6A	Board Certified* Neurologist; or Physical Medicine and Rehabilitation (PMR) Physician with additional certification by: a) American Board of Electrodiagnostic Medicine, b) Clinical Neurophysiology, or c) American Board of Neurophysiology; or a Physical Therapist who is certified by the American Board of Physical Therapy Specialties (ABPTS) as a qualified clinical electrophysiology specialist and is permitted to provide the service under state law.	Procedure must be personally performed by a qualified physician who may or may not be the supervising physician. The qualified performing physician when assisted must provide personal supervision during the performance of EMG test(s) to the IDTF technician providing assistance. In addition, EMG procedures may be personally performed by a Physical Therapist (PT) with ABPTS certification and certification in this specific procedure. The following are considered appropriate credentials to assist a physician performing an EMG: AAET: R. NCS.T, ABEM: CNCT or State Licensed Physical Therapist with ABPTS certification.
95870	6A	Board Certified* Neurologist; or Physical Medicine and Rehabilitation (PMR) Physician with additional certification by: a) American Board of Electrodiagnostic Medicine, b) Clinical Neurophysiology, or c) American Board of Neurophysiology; or a Physical Therapist who is certified by the American Board of Physical Therapy Specialties (ABPTS) as a qualified clinical electrophysiology specialist and is permitted to provide the service under state law.	Procedure must be personally performed by a qualified physician who may or may not be the supervising physician. The qualified performing physician when assisted must provide personal supervision during the performance of EMG test(s) to the IDTF technician providing assistance. In addition, EMG procedures may be personally performed by a Physical Therapist (PT) with ABPTS certification and certification in this specific procedure. The following are considered appropriate credentials to assist a physician performing an EMG: AAET: R. NCS.T, ABEM: CNCT or State Licensed Physical Therapist with ABPTS certification.
95872	66	Board Certified* Neurologist; or Physical Medicine and Rehabilitation (PMR) Physician with additional certification by: a) American Board of Electrodiagnostic Medicine, b) Clinical Neurophysiology, or c) American Board of Neurophysiology; or a Physical Therapist who is certified by the American Board of Physical Therapy Specialties (ABPTS) as a qualified clinical electrophysiology specialist and is permitted to provide the service under state law.	Procedure must be personally performed by a qualified physician who may or may not be the supervising physician. The qualified performing physician when assisted must provide personal supervision during the performance of EMG test(s) to the IDTF technician providing assistance. In addition, EMG procedures may be personally performed by a Physical Therapist (PT) with ABPTS certification and certification in this specific procedure. The following are considered appropriate credentials to assist a physician performing an EMG: AAET: R. NCS.T, ABEM: CNCT or State Licensed Physical Therapist with ABPTS certification.
95875	03	Board Certified* Neurologist or Physiatrist	Credentialed by ABRET: R. EP T.
95885	6A	Board Certified* Neurologist; or Physical Medicine and Rehabilitation (PMR) Physician with additional certification by: a) American Board of Electrodiagnostic Medicine, b) Clinical Neurophysiology, or c) American Board of Neurophysiology; or a Physical Therapist who is certified by the American Board of Physical Therapy Specialties (ABPTS) as a qualified clinical electrophysiology specialist and is permitted to provide the service under state law.	Procedure must be personally performed by a qualified physician who may or may not be the supervising physician. The qualified performing physician when assisted must provide personal supervision during the performance of EMG test(s) to the IDTF technician providing assistance. In addition, EMG procedures may be personally performed by a Physical Therapist (PT) with ABPTS certification and certification in this specific procedure. The following are considered appropriate credentials to assist a physician performing an EMG: AAET: R. NCS.T, ABEM: CNCT or State Licensed Physical Therapist with ABPTS certification.
95886	6A	Board Certified* Neurologist; or Physical Medicine and Rehabilitation (PMR) Physician with additional certification by: a) American Board of Electrodiagnostic Medicine, b) Clinical Neurophysiology, or c) American Board of Neurophysiology; or a Physical Therapist who is certified by the American Board of Physical Therapy Specialties (ABPTS) as a qualified clinical electrophysiology specialist and is permitted to provide the service under state law.	Procedure must be personally performed by a qualified physician who may or may not be the supervising physician. The qualified performing physician when assisted must provide personal supervision during the performance of EMG test(s) to the IDTF technician providing assistance. In addition, EMG procedures may be personally performed by a Physical Therapist (PT) with ABPTS certification and certification in this specific procedure. The following are considered appropriate credentials to assist a physician performing an EMG: AAET: R. NCS.T, ABEM: CNCT or State Licensed Physical Therapist with ABPTS certification.
95887	6A	Board Certified* Neurologist; or Physical Medicine and Rehabilitation (PMR) Physician with additional certification by: a) American Board of Electrodiagnostic Medicine, b) Clinical Neurophysiology, or c) American Board of Neurophysiology; or a Physical Therapist who is certified by the American Board of Physical Therapy Specialties (ABPTS) as a qualified clinical electrophysiology specialist and is permitted to provide the service under state law.	Procedure must be personally performed by a qualified physician who may or may not be the supervising physician. The qualified performing physician when assisted must provide personal supervision during the performance of EMG test(s) to the IDTF technician providing assistance. In addition, EMG procedures may be personally performed by a Physical Therapist (PT) with ABPTS certification and certification in this specific procedure. The following are considered appropriate credentials to assist a physician performing an EMG: AAET: R. NCS.T, ABEM: CNCT or State Licensed Physical Therapist with ABPTS certification.
95905	01	Board Certified* Neurologist, Physiatrist or Podiatrist	Credentialed by AAET: R. NCS.T, ABRET: R. EPT, State Licensed Physical Therapist with ABPTS certification, Qualified Physical Therapist or ABEM: CNCT
95907	7A	Board Certified* Neurologist, Physiatrist or Podiatrist – General supervision level applies if PT not certified	Credentialed by AAET: R. NCS.T, ABRET: R. EPT, State Licensed Physical Therapist with ABPTS certification, Qualified Physical Therapist or ABEM: CNCT
95908	7A	Board Certified* Neurologist, Physiatrist or Podiatrist- General supervision level applies if PT not certified	Credentialed by AAET: R. NCS.T, ABRET: R. EPT, State Licensed Physical Therapist with ABPTS certification or Qualified Physical Therapist or ABEM: CNCT
95909	7A	Board Certified* Neurologist, Physiatrist or Podiatrist- General supervision level applies if PT not certified	Credentialed by AAET: R. NCS.T, ABRET: R. EPT, State Licensed Physical Therapist with ABPTS certification, Qualified Physical Therapist or ABEM: CNCT
95910	7A	Board Certified* Neurologist or Physiatrist or Podiatrist- General supervision level applies if PT not certified	Credentialed by AAET: R. NCS.T, ABRET: R. EPT, State Licensed Physical Therapist with ABPTS certification, Qualified Physical Therapist or ABEM: CNCT
95911	7A	Board Certified* Neurologist or Physiatrist or Podiatrist- General supervision level applies if PT not certified	Credentialed by AAET: R. NCS.T, ABRET: R. EPT, or State Licensed Physical Therapist with ABPTS certification, Qualified Physical Therapist or ABEM: CNCT
95912	7A	Board Certified* Neurologist or Physiatrist or Podiatrist- General supervision level applies if PT not certified	Credentialed by AAET: R. NCS.T, ABRET: R. EPT, State Licensed Physical Therapist with ABPTS certification, Qualified Physical Therapist or ABEM: CNCT
95913	7A	Board Certified* Neurologist or Physiatrist- General supervision level applies if PT not certified	Credentialed by AAET: R. NCS.T, ABRET: R. EPT, State Licensed Physical Therapist with ABPTS certification, Qualified Physical Therapist or ABEM: CNCT
95919	01	Board Certified* Neurologist or Physiatrist	Credentialed by AAET: R. NCS.T
95921	02	Board Certified* Neurologist or Physiatrist	Credentialed by AAET: R. NCS.T
95922	03	Board Certified* Neurologist or Physiatrist	Credentialed by AAET: R. NCS.T
95923	03	Board Certified* Neurologist or Physiatrist	Credentialed by AAET: R. NCS.T
95924	09	Board Certified* Neurologist or Physiatrist	Credentialed by AAET: R. NCS.T
95925	21	Board Certified* Neurologist or Physiatrist	Credentialed by ABRET: R. EP T. or R. EEG T. or State Licensed Qualified Physical Therapist or ABPTS Physical Therapist
95926	21	Board Certified* Neurologist, Physiatrist or Podiatrist	Credentialed by ABRET: R. EP T. or R. EEG T. or State Licensed Qualified Physical Therapist or ABPTS Physical Therapist
95927	21	Board Certified* Neurologist or Physiatrist	Credentialed by ABRET: R. EP T. or R. EEG T. or State Licensed Qualified Physical Therapist or ABPTS Physical Therapist
95928	09	Board Certified* Neurologist or Physiatrist	Credentialed by ABRET: R. EPT or R. EEG T.
95929	09	Board Certified* Neurologist or Physiatrist	Credentialed by ABRET: R. EPT or R. EEG T.
95930	09	Board Certified* Neurologist, Physiatrist or appropriately trained Optometrist	Credentialed by ABRET: R. EPT or R. EEG T.
95933	7A	Board Certified* Neurologist or Physiatrist – General Supervision level applies if PT not certified	Credentialed by AAET: R. NCS.T, State Licensed Physical Therapist with ABPTS certification or Qualified Physical Therapist or ABEM: CNCT
95937	7A	Board Certified* Neurologist, Physiatrist or Podiatrist – General Supervision level applies if PT not certified	Credentialed by AAET: R. NCS.T, State Licensed Physical Therapist with ABPTS certification or Qualified Physical Therapist or ABEM: CNCT
95938	21	Board Certified* Neurologist or Physiatrist	Credentialed by ABRET: R. EP T. or R. EEG T. or State Licensed Qualified Physical Therapist or ABPTS Physical Therapist
95939	21	Board Certified* Neurologist or Physiatrist	Credentialed by ABRET: R. EP T. or R. EEG T. or State Licensed Qualified Physical Therapist or ABPTS Physical Therapist
95954	03	Board Certified* Neurologist	Credentialed by ABRET: R. EEG T
95957	01	Board Certified* Neurologist	Credentialed by ABRET: R. EEG T
95958	03	Board Certified* Neurologist	Credentialed by ABRET: R. EEG T
96105	04	Board Certified* Psychiatrist, Clinical Psychologist or Qualified Independent Psychologist	Physician Service Code – must be performed by a physician
96110	04	Board Certified* Psychiatrist, Clinical Psychologist or Qualified Independent Psychologist	Physician Service Code – must be performed by a physician
96112	04	Board Certified* Psychiatrist, Clinical Psychologist or Qualified Independent Psychologist	Physician Service Code – must be performed by a physician or other qualified health care professional
96113	04	Board Certified* Psychiatrist, Clinical Psychologist or Qualified Independent Psychologist	Physician Service Code – must be performed by a physician or other qualified health care professional
96116	04	Board Certified* Psychiatrist, Clinical Psychologist or Qualified Independent Psychologist	Physician Service Code – must be performed by a physician or other qualified health care professional
96121	04	Board Certified* Psychiatrist, Clinical Psychologist or Qualified Independent Psychologist	Physician Service Code – must be performed by a physician or other qualified health care professional
96130	04	Board Certified* Psychiatrist, Clinical Psychologist or Qualified Independent Psychologist	Physician Service Code – must be performed by a physician or other qualified health care professional
96131	04	Board Certified* Psychiatrist, Clinical Psychologist or Qualified Independent Psychologist	Physician Service Code – must be performed by a physician or other qualified health care professional
96132	04	Board Certified* Psychiatrist, Clinical Psychologist or Qualified Independent Psychologist	Physician Service Code – must be performed by a physician or other qualified health care professional
96133	04	Board Certified* Psychiatrist, Clinical Psychologist or Qualified Independent Psychologist	Physician Service Code – must be performed by a physician or other qualified health care professional
96136	04	Board Certified* Psychiatrist, Clinical Psychologist or Qualified Independent Psychologist	Physician Service Code – must be performed by a physician or other qualified health care professional
96137	04	Board Certified* Psychiatrist, Clinical Psychologist or Qualified Independent Psychologist	Physician Service Code – must be performed by a physician or other qualified health care professional
96138	04	Board Certified* Psychiatrist, Clinical Psychologist or Qualified Independent Psychologist	Physician Service Code – must be performed by a physician or other qualified health care professional
96139	04	Board Certified* Psychiatrist, Clinical Psychologist or Qualified Independent Psychologist	Physician Service Code – must be performed by a physician or other qualified health care professional
96146	04	Board Certified* Psychiatrist, Clinical Psychologist or Qualified Independent Psychologist	Physician Service Code – must be performed by a physician or other qualified health care professional
0509T	01	Board Certified* Ophthalmologist, Neurologist or Optometrist	Credentialed by JCAHPO: COT or COMT
0554T	09	Board Certified* Radiologist or Urologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
0555T	09	Board Certified* Radiologist or Urologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
0556T	09	Board Certified* Radiologist or Urologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
0557T	09	Board Certified* Radiologist or Urologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
0558T	09	Board Certified* Radiologist or Urologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-CT
0604T	09	Board Certified* Ophthalmologist or Optometrist	N/A
0605T	09	Board Certified* Ophthalmologist or Optometrist	N/A
0606T	09	Board Certified* Ophthalmologist or Optometrist	N/A
0607T	09	Board Certified* Cardiologist	State Licensed RN or Paramedic or Credentialed by NHA: CET or CCI: CCT or CRAT
0608T	09	Board Certified* Cardiologist	State Licensed RN or Paramedic or Credentialed by NHA: CET or CCI: CCT or CRAT
0609T	09	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: MR or ARMRIT: MRI
0610T	09	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: MR or ARMRIT: MRI
0611T	09	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: MR or ARMRIT: MRI
0612T	09	Board Certified* Radiologist or Neurologist with ASN or UCNS: Neuroimaging Subspecialty Certification	Credentialed by ARRT: MR or ARMRIT: MRI
0615T	09	Board Certified* Neurologist	N/A
0648T	09	Board Certified* Radiologist, Gastroenterologist or Hepatologist	Credentialed by ARRT: MR or ARMRIT: MRI
0649T	09	Board Certified* Radiologist, Gastroenterologist or Hepatologist	Credentialed by ARRT: MR or ARMRIT: MRI
0683T	02	Board Certified* Cardiologist	State Licensed: RN or Paramedic or Credentialed by CCI: CCT or NHA: CET
0685T	02	Board Certified* Cardiologist	State Licensed: RN or Paramedic or Credentialed by CCI: CCT or NHA: CET
0689T	01	Board Certified* Radiologist	Credentialed by ARDMS: RDMS or ARRT: R.T.-S
0690T	01	Board Certified* Radiologist	Credentialed by ARDMS: RDMS or ARRT: R.T.-S
0694T	01	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R
0696T	09	Board Certified* Cardiologist	State Licensed: RN or Paramedic or Credentialed by CCI: CCT or NHA: CET
0697T	02	Board Certified* Radiologist, Gastroenterologist or Hepatologist	Credentialed by ARRT: MR or ARMRIT: MRI
0698T	02	Board Certified* Radiologist, Gastroenterologist or Hepatologist	Credentialed by ARRT: MR or ARMRIT: MRI
0723T	09	Board Certified* Radiologist, Gastroenterologist or Hepatologist	Credentialed by ARRT: MR or ARMRIT: MRI
0724T	09	Board Certified* Radiologist, Gastroenterologist or Hepatologist	Credentialed by ARRT: MR or ARMRIT: MRI
0742T	01	Board Certified* Nuclear Medicine, Cardiology or Radiology	Credentialed by ARRT: N or NMTCB: CNMT
0764T	09	Board Certified* Internist or Cardiologist	RN, LPN/LVN or State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
0765T	09	Board Certified* Internist or Cardiologist	RN, LPN/LVN or State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
0779T	09	Board Certified* Gastroenterologist	RN
0804T	09	Board Certified* Cardiologist	RN, State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
0868T	01	Board Certified* Gastroenterologist	RN
0876T	01	Board Certified* Radiologist or Vascular Surgeon	Credentialed by ARDMS: RVT, ARRT: VS or CCI: RVS
0877T	09	Board Certified* Radiologist or Board Certified* Pulmonologist	Credentialed by ARRT in CT
0878T	09	Board Certified* Radiologist or Board Certified* Pulmonologist	Credentialed by ARRT in CT
0879T	09	Board Certified* Radiologist or Board Certified* Pulmonologist	Credentialed by ARRT in CT
0880T	09	Board Certified* Radiologist or Board Certified* Pulmonologist	Credentialed by ARRT in CT
0897T	01	Board Certified* Internist or Cardiologist	RN, Licensed Practical Nurse (LPN)/Licensed Vocational Nurse (LVN), or State Licensed Paramedic or Credentialed by CCI: CCT or NHA: CET
0898T	01	Board Certified* Radiologist or Urologist	Credentialed by ARDMS: RDMS or ARRT: R.T.-S
0899T	01	Board Certified* Radiologist	Credentialed by ARRT: MR or ARMRIT: MRI technologist
0900T	01	Board Certified* Radiologist	Credentialed by ARRT: MR or ARMRIT: MRI technologist
G0106	03	Board Certified* Gastroenterologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-N or NMTCB: CNMT
G0130	01	Board Certified* Radiologist or Orthopaedic Surgeon	State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-BD
G0235	01	Board Certified* Nuclear Medicine or Radiology	State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-N or NMTCB: CNMT
G0248	01	Board Certified* Cardiologist	RN
G0249	01	Board Certified* Cardiologist	Demonstrates Proficiency
G0279	09	Board Certified* Radiologist	State License: General Radiographer or Credentialed by ARRT: R.T.-R and ARRT: R.T.-M
G0398	09	Physician Certified by ABSM or ABMS: Sleep Medicine OR ABFM, ABIM, ABOHNS, ABPN or AOA: Sleep Medicine Subspecialty Certification	Credentialed by BRPT: RPSGT or CPSGT, ABRET: R. EEG T. (Polysomnography) or NBRC: CRT, SDS or RRT
G0399	09	Physician Certified by ABSM or ABMS: Sleep Medicine OR ABFM, ABIM, ABOHNS, ABPN or AOA: Sleep Medicine Subspecialty Certification	Credentialed by BRPT: RPSGT or CPSGT, ABRET: R. EEG T. (Polysomnography) or NBRC: CRT, SDS or RRT
G0400	09	Physician Certified by ABSM or ABMS: Sleep Medicine OR ABFM, ABIM, ABOHNS, ABPN or AOA: Sleep Medicine Subspecialty Certification	Credentialed by BRPT: RPSGT or CPSGT, ABRET: R. EEG T. (Polysomnography) or NBRC: CRT, SDS or RRT
Q0035	01	Board Certified* Cardiologist	Credentialed by CCI: CCT, NHA: CET, State Licensed Paramedic or RN

*Note: The CPT/HCPCS codes that have “Licensed Audiologist” designated with an asterisk in the “Technician Qualification Requirements” column would not be subject to direct supervision of a physician. Licensed Audiologist designated with an asterisk are for CPT/HCPCS codes included on the CMS Audiology Code List (revised CY2023). As defined in the Social Security Act, section 1861(ll) (3), the term “audiology services” specifically means such hearing and balance assessment services furnished by a qualified audiologist as the audiologist is legally authorized to perform under State law (or the State regulatory mechanism provided by State law), as would otherwise be covered if furnished by a physician. Additional information on Audiology Services and the CMS Audiology Code List may be found on the CMS website at https://www.cms.gov/Medicare/Medicare-Fee-For-Service-Payment/PhysicianFeeSched/audiology.html

Note: The technical component (TC) of services represented by CPT codes 95925-95927 and 95938-95939 may be performed by an appropriately certified PT. However, in an IDTF supervision by the appropriate physician(s) is required for global and professional component (PC) billing.

Please refer to A56773, Billing and Coding: Neurophysiology Evoked Potentials for additional information on CPT codes 92651-92653, 95925-95930, 95938 and 95939.

Note: Board Certified* Nuclear Medicine meets the supervising physician and interpreting physician qualification requirements for the tests 93015, 93016, 93017, and 93018 when performed in conjunction with myocardial perfusion and cardiac blood pool imaging studies. In this situation, a Certified Nuclear Medicine Technologist (ARRT: N or NMTCB: CNMT) meets the technician qualification requirements for 93015, 93016, and 93017 when performed under direct supervision of a Board Certified* Nuclear Medicine physician.

Note: Nonphysician practitioners such as nurse practitioners (NPs), clinical nurse specialists (CNSs) and physician assistants (PAs) who personally perform diagnostic psychological and neuropsychological tests are excluded from having to perform these tests under the general supervision of a physician or a clinical psychologist (CP). Rather, NPs and CNSs must perform such tests under the requirements of their respective benefit instead of the requirements for diagnostic psychological and neuropsychological tests. Accordingly, NPs and CNSs must perform tests in collaboration (as defined under Medicare law at section 1861(aa)(6) of the Act) with a physician. PAs perform tests under the general supervision of a physician as required for services furnished under the PA benefit. (Reference CMS IOM Pub. 100-02, Chapter 15, Section 80.2)

Key for IDTF Table Abbreviations

American Association of Electrodiagnostic Technologists (AAET)

http://www.aaet.info

Registered Nerve Conduction Study Technologist (R.NCS.T.)

American Board of Electrodiagnostic Medicine (ABEM)

http://www.abemexam.org/

Certified Nerve Conduction Technologist (CNCT)

American Board of Family Medicine (ABFM)

http://www.theabfm.org

ABFM: Sleep Medicine Subspecialty Certification

American Board of Internal Medicine (ABIM)

https://www.abim.org/certification/policies/internal-medicine-subspecialty-policies/sleep-medicine

ABIM: Sleep Medicine Subspecialty Certification

American Board of Nuclear Medicine (ABNM)

http://www.abnm.org

American Board of Otolaryngology - Head and Neck Surgery (ABOHNS)

https://www.abohns.org/

ABOHNS: Sleep Medicine Subspecialty Certification

American Board of Psychiatry and Neurology (ABPN)

http://www.abpn.com

ABPN: Sleep Medicine Subspecialty Certification

American Board of Medical Specialties (ABMS)

http://www.abms.org

American Board of Physical Therapy Specialties (ABPTS)

https://specialization.apta.org

ABPTS Physical Therapist

American Board of Registration of Electroencephalographic and Evoked Potential Technologists (ABRET)

http://www.abret.org/exam_info/eligibility.php

Registered Electroencephalographic technologist (R. EEG T.)

Registered Evoked Potential Technologist (R. EP T.)

American Board of Sleep Medicine (ABSM)

www.absm.org

American Osteopathic Association (AOA)

https://osteopathic.org

AOA Doctor of Osteopathic Medicine (D.O.)

American Registry of Diagnostic Medical Sonographers (ARDMS)

http://www.ardms.org

Registered Diagnostic Cardiac Sonographer (RDCS)

Registered Diagnostic Medical Sonographer (RDMS)

Registered Vascular Technologist (RVT)

American Registry of Magnetic Resonance Imaging Technologists (ARMRIT)

http://www.armrit.org/

Certified Magnetic Resonance Imaging Technologist (MRI technologist)

American Society of Neuroimaging (ASN)

http://www.asnweb.org/

ASN: Neuroimaging Subspecialty Certification

The American Registry of Radiologic Technologists (ARRT)

https://www.medical-professionals.com/en/arrt-certification-guide/

Certified Magnetic Resonance Imaging Technologist (ARRT: MR) Certified and Registered Technologist -Bone Densitometry (R.T-BD) Certified and Registered Technologist-Breast Sonography (R.T.-BS)

Certified and Registered Technologist – Cardiac Interventional Radiography (ARRT: CI Certified and Registered Technologist -Computed Tomography [R.T.-CT])

Certified and Registered Technologist -Magnetic Resonance Imaging (R.T.-MR) Certified and Registered Technologist-Mammography (R.T.-M)

Certified and Registered Technologist-Nuclear Medicine Technology (R.T.-N)

Certified and Registered Technologist-Radiography (R.T.-R)

Certified and Registered Technologist –Sonography (R.T.-S)

Certified and Registered Technologist –Vascular Sonography (R.T.-VS)

The Board of Certification of the Ophthalmic Photographers’ Society

https://mail.opsweb.org/Certif/Certif.html

Certified Retinal Angiographer (CRA)

Board of Registered Polysomnographic Technologists (BRPT)

http://www.brpt.org/

Registered Polysomnographic Technologist (RPSGT)

Certified Polysomnographic Technician (CPSGT)

Cardiovascular Credentialing International (CCI)

http://www.cci-online.org/

Certified Cardiographic Technician (CCT)

Registered Cardiac Sonographer (RCS)

Registered Cardiovascular Invasive Specialist (RCIS)

Registered Vascular Specialist (RVS)

Certified Rhythm Analysis Technician (CRAT)

The International Society for Clinical Densitometry (ISCD)

http://www.iscd.org/

Certified Bone Densitometry Technologist (CBDT)

Joint Commission on Allied Health Personnel in Ophthalmology (JCAHPO)

https://www.jcahpo.org/certification/certifications/

JCAHPO offers three levels of certification:

Certified Ophthalmic Assistant (COA)

Certified Ophthalmic Technician (COT) (Intermediate Level)

Certified Ophthalmic Medical Technologist (COMT) (Advanced Level)

National Board for Respiratory Care (NBRC)

http://www.nbrc.org

Certified Pulmonary Function Technologist (CPFT)

Registered Pulmonary Function Technologist (RPFT)

Certified Respiratory Therapist (CRT)

Sleep Disorders Specialist (SDS)

Registered Respiratory Therapist (RRT)

National Healthcareer Association (NHA)

https://www.nhanow.com/

Certified EKG Technician (CET)

Nuclear Medicine Technology Certification Board (NMTCB)

http://www.nmtcb.org/

Certified Nuclear Medicine Technologist (CNMT)

United Council for Neurologic Subspecialties (UCNS)

http://www.ucns.org/

UCNS: Neuroimaging Subspecialty Certification

Response To Comments

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Coding Information

Bill Type Codes

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Revenue Codes

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Group 1 Codes

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ICD-10-CM Codes that Support Medical Necessity

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It is the provider’s responsibility to select codes carried out to the highest level of specificity and selected from the ICD-10-CM code book appropriate to the year in which the service is rendered for the claim(s) submitted.

Group 1 Codes

Code	Description
XX000	Not Applicable

ICD-10-CM Codes that DO NOT Support Medical Necessity

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Group 1 Codes

Code	Description
XX000	Not Applicable

ICD-10-PCS Codes

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Additional ICD-10 Information

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Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the article should be assumed to apply equally to all claims.

Code	Description
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Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes.

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Other Coding Information

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Coding Table Information

Excluded CPT/HCPCS Codes - Table Format

Code	Descriptor Generic Name	Descriptor Brand Name	Exclusion Effective Date	Exclusion End Date	Reason for Exclusion
			N/A	N/A

Non-Excluded CPT/HCPCS Ended Codes - Table Format

Code	Descriptor Generic Name	Descriptor Brand Name	Exclusion Effective Date	Exclusion End Date	Reason for Exclusion

Revision History Information

Revision History Date	Revision History Number	Revision History Explanation
11/07/2024	R24	Article revised and published on 11/07/2024 effective for dates of service on and after 07/01/2024. Codes 0877T, 0878T, 0879T, and 0880T became effective 07/01/2024 and were added to the Credentialing Matrix and the Group 1 CPT/HCPCS Codes sections.
09/19/2024	R23	Article revised and published on 09/19/2024. HCPCS codes 76981, 76982, and 76983 have been added to the Credentialing Matrix and the Group 1 CPT/HCPCS Codes sections. This revision is in response to an inquiry.
09/05/2024	R22	Article revised and published on 09/05/2024 to correct typographical errors in Revision History Number R19 below. The Revision History Date listed should be 04/01/2024. Also, In the Public Versions Section Updated on 03/27/2024, the effective dates should be 04/01/2024-04/24/2024.
07/01/2024	R21	Article revised and published on 07/18/2024. Codes 0868T, 0876T, 0897T, 0898T, 0899T, and 0900T became effective 07/01/2024 and were added to the Credentialing Matrix and the Group 1 CPT/HCPCS Codes sections. CPT 95024 had a short descriptor change. This revision is in response to the July Quarterly CPT/HCPCS Update.
04/25/2024	R20	Article revised and published on 04/25/2024 effective for dates of service on and after 01/01/2024. Codes 93297 and 93298 in the Credentialing Matrix have updated supervision levels and technician qualification requirements. This is in response to an inquiry. The following CPT codes have been added to Group 1 CPT/HCPCS codes section: 91110, 91111, 92230, 92511. The Physician Supervision of Diagnostic Procedures section has been reformatted into a table. The following sentence has been removed under the above table: The level of physician supervision required for diagnostic procedures can be found in the Medical Physician Fee Schedule Database (MPFSDB). Minor typographical corrections.
04/04/2024	R19	Article revised and published on 04/04/2024. The following CPT codes have been added to the ‘Credentialing Matrix’ with applicable levels of physician supervision and technician requirements: 19000, 19001, 19281, 19283, 19285, 20501, 23350, 24220, 25246, 27093, 27095, 42550, 51600, 51610, 51798, 58340, 62284, 62302, 62303, 62304, 62305, 70554, 70555, 86485, 86490, 86580, 91110, 91111, 92025, 92230, 92511, 92611, 93792, 94774, 94775, 94776, 94777, 95004, 95024, 95027, 96112, 96113, 96116, 96121, 96130, 96131, 96132, 96133, 96136, 96137, 96138, 96139, and 96146. Within the ‘Credentialing Matrix’ the physician supervision requirements have been updated for the following codes: 76881 and 76882 requires level 09, 95806 requires level 01. The following code has been added to Group 2 CPT/HCPCS codes: A4648. In response to the April Quarterly CPT/HCPCS Update, the following codes have been deleted from Group 2 CPT/HCPCS codes: J1020, J1030, and J1040. Additionally, the article text has been revised to include billing and coding information from the LCD as the LCD is being retired. This information includes updated IOM and CFR references, physician requirements, and additional services/supplies. The ‘Credentialing Matrix’, CPT/HCPCS Group 1 and 2 Codes have been updated to be uniform across jurisdictions.
01/01/2024	R18	Article revised and published on 01/25/2024 effective for dates of service on and after 01/01/2024 to reflect the Annual HCPCS/CPT Code Updates. The following CPT codes have been added to the ‘Credentialing Matrix’ with applicable levels of physician supervision and supervising physician and technician qualification requirements, and to the CPT/HCPCS Group 1 Codes: 75580, 93584, 93585, 93586, 93587 and 93588. The following HCPCS codes have been added to the CPT/HCPCS Group 2 Codes: A9608 and A9609. The following CPT/HCPCS codes have been deleted and therefore have been removed from the article: 74710, 0501T, 0502T, 0503T, 0504T, 0508T and G2066. For the following CPT/HCPCS codes either the short description and/or the long description was changed. Depending on which description is used in this article, there may not be any change in how the code displays: 92060, 92081, 92082, 92083, 92100, 92235, 92240, 92242, 92250, 92265, 92270, 92283, 92285, 92286, 93241, 93242, 93243, 93244, 93245, 93246, 93247, 93248 (CPT/HCPCS Group 1 Codes). The article was also revised in response to an inquiry. The following statement near the bottom of the ‘Physician Supervision of Diagnostic Procedures’ section: Note: The minimal level of physician supervision, which applies to ALL diagnostic tests, with the exceptions listed in the regulation, is “general supervision” has been replaced with the following: “The provider is responsible for adhering to applicable CMS regulations for diagnostic test supervision.”
10/01/2023	R17	Article revised and published on 10/05/2023 effective for dates of service on and after 10/01/2023 to reflect the October Quarterly CPT/HCPCS Update. The following HCPCS code has been added to the article: A9573 in Group 2 Codes.
07/20/2023	R16	Article revised and published on 07/20/2023 effective for dates of service on and after 07/20/2023 in response to an inquiry. The ‘Technician Qualification Requirements’ in the ‘Credentialing Matrix’ have been revised to change ‘State License: General Radiographer’ and ‘CRT-R to ‘State License: General Radiographer or Credentialed by ARRT: Radiography (R.T.-R). The 2nd paragraph under the ‘Credentialing Matrix’ section has been revised to add additional medical specialty boards that are part of the ABMS and are included in the ‘Supervising Physician Qualification Requirements’ section of the ‘Credentialing Matrix’. The ‘Technician Qualification Requirements’ have also been revised for the following CPT/HCPCS Codes: 0508T, 0607T, 0608T, 0764T-0765T, 76706, 92550, 92557, 92567-92568, 92570, 92579, 92601-92604, 93000, 93005, 93015-93017, 93229, 93241-93243, 95782-95783, 95800-95801, 95805, 95806, 95807, 95808, 95810, 95811, 95925-95927, 95938-95939, G0398-G0400 and G2066. An asterisk note has been added under the ‘Credentialing Matrix’ for Licensed Audiologist*. The ‘Supervising Physician Qualification Requirements’ have been revised for the following CPT/HCPCS Codes: 0508T, 27369, 75774, 76706, 76801, 76802, 76805, 76810-76821, 76825-76828, 76856–76857, 93015-93017, 93018, 93325, 93975-93976, 95782-95783, 95800-95801, 95805, 95806, 95807, 95808, 95810, 95811, 95930 and G0398-G0400. The following sections were added under the ‘Credentialing Matrix’: ‘Key for IDTF Table Abbreviations’ and ‘JW and JZ Modifiers’. In response to the July Quarterly HCPCS/CPT Code Updates, the following code has been added to the ‘Credentialing Matrix’ with applicable levels of physician supervision and supervising physician and technician qualification requirements, and to the ‘CPT/HCPCS Codes’ section for ‘Group 1 Codes’: 0804T which became effective on 07/01/2023. Minor formatting changes have been made throughout the article.
01/01/2023	R15	Article revised and published on 01/26/2023 effective for dates of service on and after 01/01/2023 to reflect the Annual HCPCS/CPT Code Updates. The following CPT codes have been added to the ‘Credentialing Matrix’ with applicable levels of physician supervision and supervising physician and technician qualification requirements, and to the ‘CPT/HCPCS Codes’ section for ‘Group 1 Codes’: 76883, 95919, 0742T, 0764T, 0765T and 0779T. The following HCPCS code has been added to the 'CPT/HCPCS Codes' section for 'Group 2 Codes': J1611. For the following CPT codes either the short description and/or the long description was changed. Depending on which description is used in this article, there may not be any change in how the code displays: 76882, 78803, 78830, 78831, 78832, 92229 and 92284 in Group 1 Codes.
12/08/2022	R14	Article revised and published on 12/08/2022 in response to inquiries. CPT code 27648 has been added to the ‘Credentialing Matrix’ with Physician Supervision Level of 9; Supervising Physician Qualification Requirements - Board Certified Radiologist, Orthopedist or Podiatrist, and Technician Qualification Requirements - CRT-R. CPT code 27648 has also been added to the ‘CPT/HCPCS Codes’ for ‘Group 1 Codes’. The ‘Supervising Physician Qualification Requirements’ in the ‘Credentialing Matrix’ has been revised for CPT code 76681 and 76682 to add Board Certified Podiatrist. CPT codes 0723T and 0724T have been added to the ‘Credentialing Matrix’ with Physician Supervision Level of 9, Supervising Physician Qualification Requirements – Board Certified Radiologist, Gastroenterologist or Hepatologist and Technician Qualification Requirements - ARRT: MR or ARMRIT: MRI. CPT codes 0723T and 0724T have also been added to the ‘CPT/HCPCS Codes’ for ‘Group 1 Codes’.
10/01/2022	R13	Article revised and published on 10/13/2022 effective for dates of service on and after 10/01/2022 to reflect the October Quarterly CPT/HCPCS Code Updates. The following HCPCS codes have been added to the ‘CPT/HCPCS Codes’ section for ‘Group 2’ codes: A9602 and A9800. Please note that Revision History R12 below should read as: Article revised and published on 9/29/2022. The following CPT/HCPCS codes have been added to the ‘Credentialing Matrix’ with applicable levels of physician supervision and supervising physician and technician qualification requirements, as well as to the CPT/HCPCS ‘Group 1 Codes:’ 95800, 95801, 95806, 0501T, 0502T, 0503T, and 0504T. An additional note has been added in the ‘Article Text’ stating IDTFs performing sleep studies per LCD L33405 (Polysomnography and Sleep Testing), must also be an accredited sleep center or laboratory.
09/29/2022	R12	Article revised and published on 9/29/2022 effective for dates of service on and after 9/29/2022. The following CPT/HCPCS codes have been added to the ‘Credentialing Matrix’ with applicable levels of physician supervision and supervising physician and technician qualification requirements, as well as to the CPT/HCPCS ‘Group 1 Codes:’ 95800, 95801, 95806, 0501T, 0502T, 0503T, and 0504T. An additional note has been added in the ‘Article Text’ stating IDTFs performing sleep studies per LCD L33405 (Polysomnography and Sleep Testing), must also be an accredited sleep center or laboratory.
07/01/2022	R11	Article revised and published on 08/04/2022 effective for dates of service on and after 07/01/2022 to reflect the July CPT/HCPCS Code Updates and response to an inquiry. HCPCS Codes have been added to ‘Group 1 Codes’ and the following HCPCS Codes have been added to ‘Group 2 Codes’: 36415, A9500, A9501, A9502, A9503, A9504, A9505, A9507, A9508, A9509, A9510, A9512, A9515, A9516, A9521, A9526, A9528, A9537, A9539, A9540, A9541, A9547, A9548, A9550, A9551, A9552, A9555, A9556, A9558, A9560, A9561, A9562, A9567, A9569, A9570, A9571, A9572, A9575, A9576, A9577, A9578, A9579, A9581, A9583, A9584, A9585, A9586, A9587, A9588, A9591, A9592, A9593, A9594, A9595, A9596, A9597, A9598, A9601, J1020, J1030, J1040, J1200, J1245, J1250, J1610, J1940, J2250, J2765, J2785, Q9950, Q9951, Q9953, Q9954, Q9955, Q9956, Q9957, Q9965, Q9966, Q9967, Q9982, Q9983. Additional note has been added to ‘Group 2 Paragraph’ related to PET codes A9597 or A9598.
01/01/2022	R10	Article revised and published on 01/20/2022 effective for dates of service on and after 01/01/2022 to reflect the Annual HCPCS/CPT Code Updates. The following CPT codes have been added to the ‘Credentialing Matrix’ with applicable levels of physician supervision and supervising physician and technician qualification requirements: 0683T, 0685T, 0689T, 0690T, 0694T, 0696T, 0697T, 0698T, 91113, 93319, 93593, 93594, 93595, 93596, 93597 and 93598. The following CPT codes have been deleted and therefore have been removed from the ‘Credentialing Matrix’: 72275, 76101, 76102, 92561, 92564, 93530, 93531, 93532, 93533, 93561, 93562 and 95943. Additionally, in response to inquiries, the following CPT codes have been added to the ‘Credentialing Matrix’ with applicable levels of physician supervision and supervising physician and technician qualification requirements: 75571 and 92229. The ‘Technician Qualification Requirements’ in the ‘Credentialing Matrix’ has also been revised to add National Healthcareer Association (NHA): Certified EKG Technician (CET) for applicable procedures.
11/11/2021	R9	Article revised and published on 11/11/2021 in response to inquiries to add CPT codes 71271 and 76391 to the ‘Credentialing Matrix’ with applicable levels of physician supervision and supervising physician and technician qualification requirements.
09/09/2021	R8	Article revised and published on 09/09/2021 in response to an inquiry to add CPT codes 0648T and 0649T to the ‘Credentialing Matrix’ with applicable level of physician supervision and supervising physician and technician qualification requirements. Minor formatting changes have also been made.
04/01/2021	R7	Article revised and published on 4.1.2021 effective for dates of service on and after 4.1.2021. The “Interpreting Physician” has been removed from the “Credentialing Matrix” table of supervision as a result of an inquiry. The following “Physician Supervision of Diagnostic Procedures” #05 was changed to reflect the IOM definition. The following CPT Codes have had supervisory changes in response to the annual updates: 0554T, 0555T, 0556T, 0557T, 0558T, 71045, 71046, 71047, 71048, 74018, 74019, 74021, 76519, 76706, 76881, 76882, 78264, 78265, 78266, & 93788.
01/01/2021	R6	Article revised and published on 02/11/2021 effective for dates of service on and after 01/01/2021 to reflect the Annual 2021 HCPCS/CPT Code Updates. CPT codes 92517, 92518, 92519, 92651, 92652, 92653, 93241, 93242, 93243, 93244, 93245, 93246, 93247, 93248 and 94619 were added to the “Credentialing Matrix” table section of this billing and coding article. Also, CPT codes 76970, 78135, 92585, 92586, 94250, 94400, 94750, 94770 and 95071 were deleted from the “Credentialing Matrix” table section of this billing and coding article. In addition, Descriptors were revised for CPT codes 71250, 71260, 71270, 74425, 76513, 78130, 94617 and 95070. Minor typographical corrections and formatting changes were made throughout the coding section.
09/24/2020	R5	Revision Number 5 Publication: September 2020 Connection LCR B2020-014 Explanation of Revision: Based on an inquiry, the “Credentialing Matrix” section of the Billing and Coding article was revised to add CPT codes 10005, 10006, 10007, 10008, 10009, 10010, 10011, 10012, and 10021. The effective date of this revision based on date of service.
07/01/2020	R4	Revision Number: 4 Publication: July 2020 Connection LCR B2020-011 Explanation of Revision: Based on the July 2020 Quarterly Update, CPT codes 0604T, 0605T, 0606T, 0607T, 0608T, 0609T, 0610T, 0611T, 0612T, and 0615T were added to the “Credentialing Matrix” table section of this billing and coding article. The effective date of this revision is based on date of service.
05/14/2020	R3	Revision Number: 3 Publication: May 2020 Connection LCR B2020-009 Explanation of Revision: Based on a review, the “Credentialing Matrix” section of the Billing and Coding article was revised to add CPT codes 19081, 19082, 19083, 19084, 19085, and 19086. The effective date of this revision is based on date of service.
01/01/2020	R2	Revision Number: 2 Publication: January 2020 Connection LCR B2020-002 Explanation of Revision: Explanation of Revision: Based on further review of the Annual 2020 HCPCS Update, HCPCS code G2066 was added. Also, a typographical error was corrected (CPT code 97516 was changed to CPT code 95716). In addition, the “Supervising Physician and Interpreting Physician Qualification Requirements” and “Technician Qualification Requirements” sections of the Credentialing Matrix in the billing and coding article were updated for CPT codes 95700, 95705-95716 and the “Technician Qualification Requirements” section of the Credentialing Matrix was updated for CPT codes 95717-95726. The effective date of this revision is based on date of service.
01/01/2020	R1	Revision Number: 1 Publication: December 2019 Connection LCR B2020-001 Explanation of Revision: Annual 2020 HCPCS Update. Added CPT codes 74221, 74248, 78429, 78430, 78431, 78432, 78433, 78434, 78830, 78831, 78832, 78835, 92549, 93985, 93986, 95700, 95705, 95706, 95707, 95708, 95709, 95710, 95711, 95712, 95713, 95714, 95715, 95716, 95717, 95718, 95719, 95720, 95721, 95722, 95723, 95724, 95725 and 95726. In addition, deleted CPT codes 74241, 74245, 74247, 74249, 74260, 78205, 78206, 78320, 78607, 78647, 78710, 78805, 78806, 78807, 93299, 95827, 95950, 95951, 95953 and 95956. Also, the Diagnostic Supervision Indicator for CPT code 78459 changed from “9” to “1”. The effective date of this revision is based on date of service.

Associated Documents

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Billing and Coding: Independent Diagnostic Testing Facility (IDTF)

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