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HCPCS P9612 · Level II · P code

P9612: Catheterization for collection of specimen, single patient, all places of service, HCPCS Level II P code

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: HCPCS Level II file: October 2026 (effective October 1, 2026); PFS relative value file: RVU26D, released August 26, 2026 (effective October 1, 2026); Clinical Laboratory Fee Schedule: 26CLABQ4 (CY2026 Q4) (effective October 1, 2026); NCCI MUE tables: 2026 Q4 (effective October 1, 2026); NCCI PTP edits: v323r0 (2026 Q4) (effective October 1, 2026); OPPS Addendum B: October 2026 (effective October 1, 2026). Next CMS release: January 1, 2027 (quarterly update) for the HCPCS Level II file and Clinical Laboratory Fee Schedule and NCCI MUE tables and NCCI PTP edits and OPPS Addendum B; RVU27A with the CY2027 PFS final rule, effective January 1, 2027 for the PFS relative value file.

Key facts for P9612

Medicare payment
$9.34
CLFS national limitation amount
Coverage code
D
special coverage instructions apply
Practitioner MUE
1
MAI 3
OPPS status
SI A
Services not paid under OPPS; paid under fee schedule or other payment system
NCCI PTP pairs
205
205 hospital outpatient
LCDs and articles
0 / 0

TL;DR

CMS describes HCPCS P9612, added in 1999, as "Catheterization for collection of specimen, single patient, all places of service". The 2026 Q4 clinical laboratory fee schedule pays P9612 $9.34 (national limitation amount). MUE limits for P9612: practitioner 1 (MAI 3, Clinical: Data); hospital outpatient 1 (MAI 3, Clinical: Data). In the NCCI PTP files v323r0 P9612 appears in 204 practitioner pairs as column 2 and 1 as column 1 (most often with 0582T, 0596T, 0597T), and in 204 hospital outpatient pairs as column 2 and 1 as column 1. No current LCD or billing article lists P9612; its HCPCS coverage code is D (special coverage instructions apply). OPPS status indicator A: Services not paid under OPPS; paid under fee schedule or other payment system. HCPCS record: BETOS T1H (lab tests - other (non-Medicare fee schedule)); pricing indicator 57/21; type of service 5 (diagnostic laboratory). 1 other active code opens with "Catheterization for collection of specimen"; related codes: P9615, P9604, P9603, P9073.

P9612 descriptor and code status

The October 2026 HCPCS Level II file describes P9612 as “Catheterization for collection of specimen, single patient, all places of service”. It sits in the P section (pathology and laboratory services), listed with the other P codes. Although searches often call it the "P9612 CPT code", P9612 is a HCPCS Level II code maintained by CMS, not an AMA CPT code; both go in the same procedure-code field on the claim.

HCPCS file attributes of P9612
FieldValue
Short descriptorCatheterize for urine spec
Added to HCPCS1999-01-01
Last actionN (no maintenance), effective 2014-01-01
Coverage codeD: special coverage instructions apply
Pricing indicator57: other contractor-priced; 21: clinical lab fee schedule, subject to the national limitation amount
BETOS categoryT1H: lab tests - other (non-Medicare fee schedule)
Type of service5: diagnostic laboratory

Medicare payment for P9612

The 2026 Q4 clinical laboratory fee schedule pays P9612 $9.34 (national limitation amount). The amounts below are national figures from the October 2026 CMS files; the contractor applies the locality, rural or state adjustment and the beneficiary's cost sharing.

Physician fee schedule (RVU26D)

Status X: statutory exclusion: not a physician service under the fee schedule. Global period XXX (global surgery concept does not apply); PC/TC indicator 9 (professional/technical concept does not apply).

Clinical Laboratory Fee Schedule (26CLABQ4)

P9612 is paid at $9.34 (national limitation amount). Laboratory fee schedule payments carry no beneficiary coinsurance or deductible.

Hospital outpatient (OPPS Addendum B)

Status indicator A (Services not paid under OPPS; paid under fee schedule or other payment system), with no separate OPPS payment rate.

Medically Unlikely Edits for P9612

MUE limits for P9612: practitioner 1 (MAI 3, Clinical: Data); hospital outpatient 1 (MAI 3, Clinical: Data). The practitioner MUE is a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation.

MUE values for P9612 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services13 Date of Service Edit: ClinicalClinical: Data
Facility outpatient hospital13 Date of Service Edit: ClinicalClinical: Data

The MUE lookup for P9612 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

In the practitioner PTP file v323r0, P9612 is the column-2 (bundled) code in 204 active pairs, 20% of which allow a modifier and the column-1 code in 1 (0% modifier-allowed); 34 earlier pairs have been deleted. CMS's most frequent rationale for the bundled pairs: Standards of medical/surgical practice.

Column-1 codes most often paired with P9612 (practitioner)
Column-1 codePairs
0582T (CPT; descriptor licensed by AMA)1
0596T (CPT; descriptor licensed by AMA)1
0597T (CPT; descriptor licensed by AMA)1
0655T (CPT; descriptor licensed by AMA)1
0664T (CPT; descriptor licensed by AMA)1
0665T (CPT; descriptor licensed by AMA)1
0666T (CPT; descriptor licensed by AMA)1
0667T (CPT; descriptor licensed by AMA)1
Column-2 codes bundled into P9612 (practitioner)
Column-2 codePairs
P9615 Urine specimen collect mult1

In the hospital outpatient PTP file v323r0, P9612 is the column-2 (bundled) code in 204 active pairs, 20% of which allow a modifier and the column-1 code in 1 (0% modifier-allowed); 34 earlier pairs have been deleted. CMS's most frequent rationale for the bundled pairs: Standards of medical/surgical practice.

Column-1 codes most often paired with P9612 (hospital outpatient)
Column-1 codePairs
0582T (CPT; descriptor licensed by AMA)1
0596T (CPT; descriptor licensed by AMA)1
0597T (CPT; descriptor licensed by AMA)1
0655T (CPT; descriptor licensed by AMA)1
0664T (CPT; descriptor licensed by AMA)1
0665T (CPT; descriptor licensed by AMA)1
0666T (CPT; descriptor licensed by AMA)1
0667T (CPT; descriptor licensed by AMA)1
Column-2 codes bundled into P9612 (hospital outpatient)
Column-2 codePairs
P9615 Urine specimen collect mult1

P9612 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Pair counts show exposure, not the answer for one claim. Check P9612 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for P9612

No current LCD or billing and coding article lists P9612. The HCPCS coverage code D means special coverage instructions apply, and any National Coverage Determination for the service still applies.

Denials to expect on P9612

CARC 50 · N115

the service is not reasonable and necessary for the diagnosis on the claim

CARC 151 · N362

units of P9612 exceed the practitioner MUE of 1 per date of service

CARC 4

the modifier reported is inconsistent with the code

CARC 16

the claim lacks the description, invoice or pricing detail a contractor-priced code needs

Where QuickIntell fits for P9612 claims

QuickCode supports qualified coder review of units, modifiers and NCCI pairs for P9612 before the claim leaves, and QuickRCM carries claim readiness and the denial follow-up when an edit or coverage policy is missed.

See QuickCode for coder reviewSee QuickRCM for denial follow-upBook a meeting

Frequently asked questions: HCPCS P9612

What does HCPCS code P9612 describe?

"Catheterization for collection of specimen, single patient, all places of service" (short descriptor "Catheterize for urine spec"), in the P section (pathology and laboratory services). Added 1999-01-01; last action N (no maintenance) effective 2014-01-01.

Is P9612 a CPT code?

No: CMS maintains P9612 in HCPCS Level II, while the AMA maintains CPT. People do search "P9612 CPT code", and it goes in the same procedure-code field.

What does Medicare pay for P9612?

The 2026 Q4 clinical laboratory fee schedule pays P9612 $9.34 (national limitation amount).

How many units of P9612 can be billed per day?

MUE limits for P9612: practitioner 1 (MAI 3, Clinical: Data); hospital outpatient 1 (MAI 3, Clinical: Data). For the practitioner MUE (MAI 3), units above 1 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.

Does Medicare cover P9612?

No current LCD or billing article lists P9612; its HCPCS coverage code is D (special coverage instructions apply).

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

This page is an operational reference compiled from CMS publications: the HCPCS Level II file, the physician, DMEPOS and clinical laboratory fee schedules, OPPS and ASC addenda, NCCI MUE, PTP and add-on edit tables and the Medicare Coverage Database. Amounts are Medicare national figures before locality and state adjustment; Medicaid and commercial payers set their own. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.