Is this a payable code? Provider has a handful of patient who he already did this services but this is the first time he is trying to bill this code. Is this done by units? I also cant find a fee schedule for this on CMS (NY NJ and CT state)
When you see a code that ends in T, it's a CPT Category III code. This means that it is a temporary code set for emerging technologies, services, and procedures. The AMA assigns these temporary codes for data collection and tracking purposes.
There are no RVUs assigned to Category III codes. Payment for the services will depend on payer policy, so you'll have to research it for each specific payer. CMS considers it a carrier-priced code. You'll likely see many payers often consider emerging technologies as investigational or only covered within a very limited set of circumstances, so I'd definitely recommend verifying with each patient's insurance before providing the service.
For example, here's a link to the United Healthcare policy guidelines for electrical stimulation and the reference to 0720T:
https://www.uhcprovider.com/content...tion-treatment-pain-muscle-rehabilitation.pdf
(Although the policy at the link is labeled UHC Commercial and Individual Exchange members, it also currently applies to Medicare Advantage patients. That reference can be found under UHC's Category III CPT Code policy for Medicare Advantage members at this link:
https://www.uhcprovider.com/content...edadv-guidelines/c/category-iii-cpt-codes.pdf )
0720T is Percutaneous electrical nerve field stimulation, cranial nerves, without implantation. According to the UHC policy linked above, Percutaneous electrical nerve field stimulation (PENFS) is on the list of services they consider "unproven and not medically necessary due to insufficient evidence of efficacy."
Most major payer websites (Aetna, Blue Cross, etc) will have clinical policy documents on the websites, similar to the one that I found for United HealthCare. Sometimes an easy way to find the document is to go to the payer's website and enter your code in the search bar.
For example, when I entered 0720T in the search bar on the Aetna website, it took me to this document:
https://www.aetna.com/cpb/medical/data/1_99/0011.html