79005 Radiopharmaceutical therapy Medicare reimbursement rates in New Jersey

This service covers therapeutic administration of a radioactive pharmaceutical by mouth. A familiar example is oral radioactive iodine treatment for hyperthyroidism or thyroid cancer. It is typically performed in a nuclear medicine department by a nuclear medicine physician or other qualified clinician, with staff and facilities prepared to handle the therapeutic dose. The route is the key distinction: the radioactive agent is swallowed rather than administered intravenously or into a body cavity.

Select this code when the documented treatment is delivered orally, not simply because a radioactive agent was ordered or dispensed. The record should support the treatment indication, agent and dose, oral route, date of administration, and responsible provider. CMS identifies separately priced professional and technical components: modifier 26 represents the professional interpretation, while modifier TC represents equipment and staff; billing without either modifier represents the global service. Use the component that matches the service furnished and billed.