P9100 HCPCS code: Pathogen(s) test for platelets
P9100 is the HCPCS Level II code for pathogen(s) test for platelets. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 12 per day on outpatient hospital claims.
Code details
| Field | Value |
|---|---|
| Section | P codes — Pathology and laboratory services |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 57 |
| BETOS category | T1H |
| Added | 2018-01-01 |
| Last action effective | 2018-01-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 12 | Clinical: CMS Workgroup |
| practitioner claims | 2 | Clinical: CMS Workgroup |
What changed for P9100
- 2018-01-01: P9100 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code P9100?
P9100 is the HCPCS Level II code for pathogen(s) test for platelets. Short descriptor: "Pathogen test for platelets".
Does Medicare cover P9100?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of P9100 can be billed per day?
12 on outpatient hospital claims; 2 on practitioner claims (NCCI medically unlikely edits).
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Next steps
- Run a reimbursement report for a device billed under P9100
- Watch P9100 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for P9100
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.