What are CPT codes used for?

• A. For medical decision making only
• B. For billing and reimbursement by insurance plans for any diagnostic or therapeutic service
• C. For inventory management
• D. For patient scheduling

Answer: (B)

CPT codes are the standardized billing codes used to describe medical services and procedures so insurance plans can reimburse providers. They create a common language for reporting what was done, covering diagnostic and therapeutic services across specialties. Along with diagnosis codes, CPT codes let payers determine coverage and payment amounts, making the billing and reimbursement process possible and predictable. They’re used by Medicare, private insurers, and other payers, and are updated annually by the AMA. They aren’t used for medical decision making, inventory management, or patient scheduling. Some services may require modifiers or be reported with related HCPCS Level II codes.