CPT code 96913: PUVA therapy, severe dermatoses, intensive schedule2026 Medicare rate & RVUs in Pennsylvania
Report this code for psoralen-UVA photochemotherapy prescribed for severe dermatoses on an intensive schedule of at least four to five treatments weekly for six to eight weeks.
Medicare pays $135.25–$153.49 for 96913 in the office in Pennsylvania, from Rest of Pennsylvania to Metropolitan Philadelphia, PA. Which amount applies depends on the service address.
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 96913 covers
This service is PUVA photochemotherapy: psoralen is administered as part of treatment, followed by controlled exposure to ultraviolet A light. Dermatologists commonly use it for severe dermatoses, including severe psoriasis, when the treatment plan calls for an intensive course. The service is provided in a dermatology or phototherapy setting by the treating clinician or trained staff operating under the required supervision.
Select this code when the documented PUVA plan meets the intensive schedule specified for severe dermatoses: at least four to five treatments per week for six to eight weeks. The record should support the diagnosis, use of psoralen and UVA, and prescribed treatment frequency and course. The code distinguishes this intensive regimen from the PUVA service reported with 96912. CMS identifies it as an incident-to service; when billed incident-to, it must be performed under physician supervision.
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 96913 pays more and less in Pennsylvania
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Philadelphia, PA | $153.49 | Unavailable |
| Rest of Pennsylvania | $135.25 | Unavailable |
How the 96913 rate is calculated
Each of 96913’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 · 96913
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense4.38
4.38 RVUs× 1.000 GPCI
Malpractice0.03
0.03 RVUs× 1.000 GPCI
Adjusted RVUs
4.4100
Conversion factor
$33.4009
Medicare rate
$147.30
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 96913
The CMS indicators that decide how 96913 is paid alongside other services.
CMS payment indicators · 96913
PUVA therapy, severe dermatoses, intensive schedule
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| 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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 5 | Incident-to service. |
96913 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 96912PUVA therapyPsoralen plus UVA
- Both describe PUVA. Choose 96913 when the severe-dermatosis regimen requires at least four to five treatments weekly for six to eight weeks; 96912 describes PUVA without that intensive schedule.
- 96910PhototherapyTar or petrolatum with UVB
- 96910 describes photochemotherapy using tar or petrolatum with UVB. 96913 is for psoralen combined with UVA.
- 96900UV light therapyActinotherapy
- 96900 is ultraviolet light treatment without the psoralen component of PUVA; 96913 describes psoralen-UVA photochemotherapy for severe dermatoses on an intensive schedule.
96913 billing questions
When should 96913 be chosen instead of 96912?
Use 96913 for PUVA treatment of severe dermatoses when the prescribed course requires at least four to five treatments weekly for six to eight weeks. Use 96912 for PUVA when that intensive schedule is not documented.
Does this service include both psoralen and UVA treatment?
Yes. The photochemotherapy service includes psoralen administration and UVA exposure; document both as part of the treatment.
What documentation supports reporting 96913?
Document the severe dermatosis, the PUVA treatment, and the prescribed frequency and course supporting the intensive schedule.
Can staff provide the service for incident-to billing?
CMS permits incident-to billing only when the service is performed under physician supervision.
Is 96913 appropriate for UVB treatment?
No. This code describes psoralen-UVA photochemotherapy. Tar or petrolatum with UVB is described by 96910.
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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