CPT code 90869: TMS Redetermination, motor Threshold2026 Medicare rate & RVUs in Massachusetts
Reports a later motor-threshold reassessment during therapeutic repetitive TMS, with treatment management, rather than initial planning or a treatment-delivery session.
CMS doesn’t publish an office rate for 90869 in Massachusetts.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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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 Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston, MA | Unavailable | Unavailable |
| Rest of Massachusetts | Unavailable | Unavailable |
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
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
90869 compared with similar codes
Compare codes · National
4 codes, side by side
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
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