Reimbursement for Quantitative MRI
Today, some institutions use established reimbursement pathways — including CPT 76498 (unlisted MRI procedure) — for advanced quantitative and perfusion‑based MRI analyses performed with IB Neuro.
76498
This code is used when a provider performs a novel, proprietary, or non‑standard MRI acquisition or post‑processing service that cannot be accurately coded using existing CPT codes.
Advancing Reimbursement for Quantitative MRI
In addition, the American Medical Association (AMA) has introduced new Category III CPT codes to support emerging approaches in quantitative brain MRI analysis, including AI‑enabled methods where applicable. These codes represent an important step in the evolution of reimbursement frameworks for advanced neuroimaging.
Imaging Biometrics continuously monitors these developments as part of our commitment to supporting the long‑term clinical adoption of quantitative imaging biomarkers.
Emerging Category III Codes (Effective Jan 1, 2024)
0865T
This code is used for quantitative MRI analysis without a diagnostic MRI examination during the same session.
+0866T
This add-on code is to be used when quantitative MRI analysis is performed in the same session with a diagnostic MRI examination. It must be reported alongside primary MRI codes (70551, 70552, 70553).
Refer to these codes for:
Brain Volume Quantification and Lesion Analysis
Comparison to prior studies AI-Assisted Quantitative MRI Interpretation
Do not refer to these codes for:
For Tissue Composition Analysis (refer to 0648T, 0649T, 0697T, or 0698T)
For CT-Based Analysis (refer to 0721T or 0722T)
If No Comparison to Prior MRI (refer to modifier 52 with 0865T or 0866T)
IMPORTANT: CPT coding decisions and reimbursement eligibility are determined by local payer policy and institutional compliance review.