US · guidance
CMS Pub. 100-04, ch. 18, § 50.4
HCPCS, Revenue, and Type of Service Codes
The appropriate bill types for billing the A/B MAC (A) on Form CMS-1450 or its electronic
equivalent are 12X, 13X, 14X, 22X, 23X, 71X, 73X, 75X, and 85X. Effective 4/1/06, type of bill
14X is for non-patient laboratory specimens.
The HCPCS code G0102 - for prostate cancer screening digital rectal examination.
• A/B MAC (B) TOS is 1
• A/B MAC (A) revenue code is 0770
The HCPCS code G0103 - for prostate cancer screening PSA tests
• A/B MAC (B) TOS is 5
• A/B MAC (A) revenue code is 030X
The HCPCS code 0359U – (PROSTATE CANCER), ANALYSIS OF ALL PROSTATE-SPECIFIC ANTIGEN (PSA) STRUCTURAL ISOFORMS BY PHASE SEPARATION AND
IMMUNOASSAY, PLASMA, ALGORITHM REPORTS RISK OF CANCER. Effective 01/01/23.
• A/B MAC (B) TOS is 5
• A/B MAC (A) revenue code is 030X
History
(Rev. 11902; Issued:03-16-23; Effective: 04-17-23; Implementation: 04-17-23)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
487ffb269114f6b479208afce144054a45b78974a699648f1ddffb29efa72a30
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