New Payment Policy: Intraoperative Neurophysiologic Monitoring
Intraoperative Neurophysiologic Monitoring (IONM) is a critical procedure used during high-risk neurosurgical, orthopedic, and vascular surgeries to monitor the integrity of neural pathways. This new IONM billing policy outlines how billing and coding for intraoperative neuromonitoring services will be recognized and reimbursed when submitted on a claim form.
Professional oversight in IONM can be provided in two ways:
- Monitoring oversight within the operating room (OR) (CPT code 95940).
- Monitoring oversight remotely outside of the OR, requiring a real-time remote connection (CPT code 95941/HCPCS code G0453).
Effective for dates of service on and after October 3, 2025, “incident to” services provided by an assisting physician, anesthesiologist, or certified technician to the monitoring physician won’t be reimbursed.
Monitoring oversight will only be reimbursed to the monitoring physician. Procedure codes 95940, 95941, and G0453 are classified as global or “complete” services and don’t have professional and technical components.
Modifiers 26 and TC don’t apply to these codes and will be denied if submitted. This new IONM billing policy aims to clarify and streamline the actual billing process for intraoperative neuromonitoring services, ensuring accurate and efficient reimbursement.
Review the key points and specific coding criteria in the policy.