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US · guidance

CMS Pub. 100-04, ch. 18, § 50.3.1

Correct Coding Requirements for A/B MAC (B) Claims

activein force · 2026-08-25 – presentas-observed

B3-4182.6

Billing and payment for a Digital Rectal Exam (DRE) (G0102) is bundled into the payment for a

covered E/M service (CPT codes 99201 - 99456 and 99499) when the two services are furnished to

a patient on the same day. If the DRE is the only service or is provided as part of an otherwise

noncovered service, HCPCS code G0102 would be payable separately if all other coverage

requirements are met.

History

(Rev. 1, 10-01-03)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
27bf1c95d3f4cb9bf130de9f92ae29c23766644318137675ffe91ad995acaeaa
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