CPT code 90869: TMS Redetermination, motor Threshold2026 Medicare rate & RVUs in Louisiana

Reports a later motor-threshold reassessment during therapeutic repetitive TMS, with treatment management, rather than initial planning or a treatment-delivery session.

CMS RVU26DEffective Oct 1, 20262 payment localities5.4K Medicare services in 2024

CMS doesn’t publish an office rate for 90869 in Louisiana.

—Office (non-facility)
—Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 9 sections
  1. Rate in Louisiana
  2. What 90869 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 90869 covers

This service covers a later motor-threshold reassessment during a course of therapeutic repetitive TMS, with treatment management. The threshold guides stimulation settings; this code is distinct from the initial planning and threshold-setting session and from subsequent sessions for treatment delivery and management. It is typically reported by the clinician or practice managing TMS, often in outpatient psychiatric care, when the threshold is re-determined during the treatment course.

Medicare assigns carrier-priced status: CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim. The code has a 0-day global period, with same-day preoperative and postoperative care included. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 90869 pays more and less in Louisiana

90869 office and facility rates by payment locality
Payment localityOfficeFacility
New Orleans, LAUnavailableUnavailable
Rest of LouisianaUnavailableUnavailable

How the 90869 rate is calculated

Each of 90869’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 90869

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.00

0.00 RVUs× 1.000 GPCI

Practice expense0.00

0.00 RVUs× 1.000 GPCI

Malpractice0.00

0.00 RVUs× 1.000 GPCI

Adjusted RVUs

0.0000

Conversion factor

$33.4009

Medicare rate

$0.00

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 90869

The CMS indicators that decide how 90869 is paid alongside other services.

CMS payment indicators · 90869

TMS Redetermination, motor Threshold

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

90869 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 90869

    TMS Redetermination, motor Threshold0 wRVU

    Not priced

  • 90867

    TMS treatment, initial mapping and treatment0 wRVU

    Not priced

  • 90868

    TMS treatment, per session0 wRVU

    Not priced

  • 90870

    Electroconvulsive therapy2.5 wRVU

    $182.03

How to choose

90867TMS treatmentInitial mapping and treatment
Use 90867 for the initial TMS session that includes treatment planning and initial motor-threshold determination. Code 90869 describes a later redetermination with treatment management.
90868TMS treatmentPer session
Use 90868 for subsequent TMS treatment delivery and management. Code 90869 describes a later motor-threshold redetermination with treatment management.
90870Electroconvulsive therapy
Code 90870 describes electroconvulsive therapy, which uses a different treatment method. Code 90869 describes motor-threshold redetermination during a course of therapeutic repetitive TMS.

90869 billing questions

When should I report this instead of 90868?

Report 90869 for a later motor-threshold redetermination with treatment management. Code 90868 describes subsequent TMS treatment delivery and management.

How does this differ from 90867?

Code 90867 describes the initial TMS session, including treatment planning and initial motor-threshold determination. Code 90869 is for a later motor-threshold redetermination with treatment management.

Does 90869 include TMS treatment delivery?

No. It covers motor-threshold redetermination with treatment management; 90868 describes subsequent treatment delivery and management.

How does Medicare price this code?

It has carrier-priced status. CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim.

Can I append modifier 50 or report an assistant surgeon?

Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates

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