Billing code 96910: PhototherapyMedicare rate & RVUs in Texas
Report this service for a dermatologic treatment session combining ultraviolet B exposure with topical tar or petrolatum as the treatment regimen.
Medicare pays $104.57–$121.45 for 96910 in the office in Texas, from Beaumont to Austin. 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.
On this page 9 sections
What 96910 covers
This service combines ultraviolet B (UVB) exposure with topical tar or petrolatum as part of a dermatologic treatment regimen. It is commonly provided in dermatology practices for conditions such as psoriasis, with the topical agent used alongside the light treatment. The session is generally carried out by dermatology staff as a physician-supervised service.
Report 96910 when the documented treatment uses tar and UVB or petrolatum and UVB; UVB exposure alone or a psoralen-and-UVA regimen represents a different service. Documentation should identify the topical agent and the UVB treatment provided for the session. CMS classifies this as an incident-to service: it is billed only when performed under physician supervision. The CMS physician fee schedule assigns no work RVUs to the service, with practice expense and malpractice RVUs supporting its payment.
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 96910 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$104.57 to $121.45
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $121.45 | Unavailable |
| Beaumont | $104.57 | Unavailable |
| Brazoria | $113.72 | Unavailable |
| Dallas | $114.35 | Unavailable |
| Fort Worth | $113.21 | Unavailable |
| Galveston | $113.98 | Unavailable |
| Houston | $114.35 | Unavailable |
| Rest Of Texas | $109.01 | Unavailable |
How the 96910 rate is calculated
Each of 96910’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 · 96910
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.00Practice expense 3.42Malpractice 0.02
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 96910
The CMS indicators that decide how 96910 is paid alongside other services.
CMS payment indicators · 96910
Phototherapy
| 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. |
96910 compared with similar codes
Compare codes
96910 vs 96900 vs 96912 vs 96913: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 96900UV light therapy
- Choose 96910 when UVB is combined with topical tar or petrolatum. Choose 96900 for UV light treatment without that topical combination.
- 96912PUVA therapy
- Code 96912 describes PUVA treatment using psoralens and UVA; 96910 uses tar or petrolatum with UVB.
- 96913PUVA therapy
- Code 96913 is for photochemotherapy to treat severe dermatoses. Code 96910 identifies the specific tar-or-petrolatum and UVB treatment regimen.
96910 billing questions
When should 96910 be chosen instead of 96900?
Use 96910 for a regimen combining UVB with topical tar or petrolatum. Code 96900 describes UV light treatment without that combination.
How does 96910 differ from PUVA treatment?
Code 96910 involves tar or petrolatum with UVB. Code 96912 is for photochemotherapy using psoralens with UVA.
What documentation supports reporting 96910?
Document the topical agent used and the UVB treatment delivered during the session. The record should support that the treatment was performed under physician supervision.
Can this service be billed when performed by clinic staff?
Yes, when it is performed under physician supervision, consistent with the CMS incident-to rule supplied for this code.
Is 96910 reported for each topical application or for the treatment session?
The service represents the combined treatment session, not a separate report for each topical application.
How does 96910 differ from 96913?
Code 96910 identifies the tar-or-petrolatum and UVB regimen. Code 96913 is for photochemotherapy used to treat severe dermatoses.
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
Show the CMS file lines behind this rate
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