CPT 78014Radiology

Thyroid imaging w/blood flow

CPT 78014 covers a nuclear medicine thyroid scan that includes images of blood flow to the thyroid gland, helping doctors evaluate thyroid function and detect abnormalities like nodules or tumors.

Showing rates for

National Average

Base Medicare rate

$207.34

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

0.5

PE RVU (NF)

5.85

MP RVU

0.06

Total RVU

6.41

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Document the dynamic blood flow imaging phase separately from static uptake images with specific timing (e.g., '2-second frame rate for 60 seconds during initial perfusion')
Impact: Prevents downcoding to 78013 ($191.17) resulting in $16.17 loss per study; blood flow documentation is the sole differentiator
Bill radiopharmaceutical separately using appropriate HCPCS code (A9512 for Tc-99m pertechnetate or A9509 for I-123 sodium iodide) with units based on actual dose administered
Impact: Radiopharmaceutical represents $30-80 additional reimbursement depending on isotope and dose; commonly overlooked revenue
For bilateral facility/non-facility settings, ensure place of service code matches actual location as both rates are identical at $207.34 but documentation requirements differ
Impact: Prevents audit exposure; while rates match for 78014, incorrect POS coding creates compliance risk and patterns may trigger review
When multiple thyroid views or delayed imaging is performed beyond standard protocol, document medical necessity but do not separately code—this is included in 78014
Impact: Prevents unbundling denials and compliance risk; additional views are inherent to complete study and not separately reimbursable
Verify medical necessity documentation includes specific indication (thyroid nodule characterization, hyperthyroidism workup, etc.) and prior imaging if applicable
Impact: Medicare LCD requirements vary by MAC; inadequate medical necessity documentation results in denial of full $207.34 payment
Submit claim within 12 months of service date with all required elements; late filing is common denial reason for imaging services with no appeal option

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 78014 in 2025?

The 2025 Medicare national average payment for CPT 78014 is $207.34 for both facility and non-facility settings. This rate is based on 6.41 total RVUs multiplied by the 2025 conversion factor of 32.3465.

What is the difference between CPT 78014 and 78013?

CPT 78014 includes dynamic blood flow imaging during the initial perfusion phase in addition to static thyroid uptake images, while CPT 78013 includes only static uptake images without blood flow assessment. The blood flow component must be documented with specific imaging protocol details to justify billing 78014.

Can CPT 78014 and 78012 be billed together on the same day?

Yes, CPT 78014 (thyroid imaging with blood flow) and 78012 (thyroid uptake measurement) can be billed together when medically necessary and performed as distinct services, but modifier 59 should be appended to 78014 to indicate a separate procedure and prevent bundling denials.

What radiopharmaceuticals are used for CPT 78014 and how are they billed?

Common radiopharmaceuticals include Tc-99m pertechnetate (HCPCS A9512) or I-123 sodium iodide (HCPCS A9509). These are billed separately from CPT 78014 using the appropriate HCPCS code with units based on the actual administered dose in millicuries.

How many RVUs is CPT code 78014 worth?

CPT 78014 has 6.41 total RVUs for 2025, consisting of 0.5 work RVU, 5.85 practice expense RVU, and 0.06 malpractice RVU. The facility and non-facility PE RVUs are the same at 5.85.

Who can perform and interpret CPT 78014 thyroid imaging studies?

CPT 78014 must be performed under the supervision of a physician certified in nuclear medicine or diagnostic radiology. The technologist should hold CNMT or ARRT(N) certification, and the facility must maintain appropriate NRC or Agreement State radioactive materials licensure.

What documentation is required to support medical necessity for CPT 78014?

Required documentation includes specific clinical indication (such as palpable thyroid nodule, abnormal thyroid function tests, or hyperthyroidism symptoms), relevant physical examination findings, pertinent laboratory results, and explanation of how imaging will impact clinical management. Generic screening indications are typically not covered.