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HCPCS Q0091 · Level II · Q code

Q0091: Screening papanicolaou smear; obtaining, HCPCS Level II Q 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); 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 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 Q0091

Medicare payment
$46.09
PFS non-facility, national; facility $15.70
Coverage code
D
special coverage instructions apply
Practitioner MUE
1
MAI 3
OPPS status
SI S
Procedure or service, not discounted when multiple
NCCI PTP pairs
89
81 hospital outpatient
LCDs and articles
0 / 0

TL;DR

HCPCS Level II Q0091 reads "Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory" in the October 2026 file; it dates from 1992. Medicare's October 2026 physician fee schedule pays Q0091 $46.09 non-facility and $15.70 facility nationally, from 0.36 work, 0.99 practice-expense and 0.03 malpractice RVUs at the $33.4009 conversion factor. Qualifying APM participants get $46.32 at $33.5675. MUE limits for Q0091: practitioner 1 (MAI 3, Anatomic Consideration); hospital outpatient 1 (MAI 3, Anatomic Consideration); DME supplier 0 (MAI 3, CMS Policy). Q0091 is a primary code for 1 add-on code (G0513). In the NCCI PTP files v323r0 Q0091 appears in 1 practitioner pairs as column 2 and 88 as column 1 (most often with G0337), and in 1 hospital outpatient pairs as column 2 and 80 as column 1. Q0091 appears in no active LCD or billing and coding article, so coverage follows HCPCS coverage code D (special coverage instructions apply) and any NCD. HCPCS record: BETOS P6C (minor procedures - other (Medicare fee schedule)); pricing indicator 11; type of service 1 (medical care). Nearby codes: Q0092, Q0111, Q0112, Q0163.

Q0091 descriptor and code status

The October 2026 HCPCS Level II file describes Q0091 as “Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory”. It sits in the Q section (temporary codes), listed with the other Q codes for services and supplies (non-drug). Although searches often call it the "Q0091 CPT code", Q0091 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 Q0091
FieldValue
Short descriptorObtaining screen pap smear
Added to HCPCS1992-01-01
Last actionN (no maintenance), effective 1996-07-01
Coverage codeD: special coverage instructions apply
Pricing indicator11: physician fee schedule, priced with national RVUs
BETOS categoryP6C: minor procedures - other (Medicare fee schedule)
Type of service1: medical care

Medicare payment for Q0091

Medicare's October 2026 physician fee schedule pays Q0091 $46.09 non-facility and $15.70 facility nationally, from 0.36 work, 0.99 practice-expense and 0.03 malpractice RVUs at the $33.4009 conversion factor. Qualifying APM participants get $46.32 at $33.5675. 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 A: active: paid separately under the physician fee schedule when covered. Global period XXX (global surgery concept does not apply); PC/TC indicator 0 (physician service; the professional/technical split does not apply).

PFS relative values and national payment for Q0091
ComponentNon-facilityFacility
Work RVU0.360.36
Practice expense RVU0.990.08
Malpractice RVU0.030.03
Total RVUs1.380.47
National payment (CF $33.4009)$46.09$15.70
Qualifying APM participant (CF $33.5675)$46.32$15.78
  • Multiple procedures (modifier 51): no multiple-procedure reduction
  • Bilateral (modifier 50): 150% bilateral adjustment does not apply
  • Assistant at surgery: assistant at surgery paid only with documentation; co-surgeons: co-surgeons not permitted; team surgery: team surgeons not permitted
  • Physician supervision of diagnostic procedures: supervision concept does not apply

Hospital outpatient (OPPS Addendum B)

Status indicator S (Procedure or service, not discounted when multiple), APC 5731 (Level 1 Minor Procedures), national unadjusted payment $29.55 with a minimum unadjusted copayment of $0.00.

Medically Unlikely Edits for Q0091

MUE limits for Q0091: practitioner 1 (MAI 3, Anatomic Consideration); hospital outpatient 1 (MAI 3, Anatomic Consideration); DME supplier 0 (MAI 3, CMS Policy). 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 Q0091 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services13 Date of Service Edit: ClinicalAnatomic Consideration
Facility outpatient hospital13 Date of Service Edit: ClinicalAnatomic Consideration
DME supplier03 Date of Service Edit: ClinicalCMS Policy

The MUE lookup for Q0091 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

In the practitioner PTP file v323r0, Q0091 is the column-2 (bundled) code in 1 active pair, 0% of which allow a modifier and the column-1 code in 88 (100% modifier-allowed); 239 earlier pairs have been deleted. CMS's most frequent rationale for the bundled pairs: Misuse of Column Two code with Column One code.

Column-1 codes most often paired with Q0091 (practitioner)
Column-1 codePairs
G0337 Hospice evaluation preelecti1
Column-2 codes bundled into Q0091 (practitioner)
Column-2 codePairs
99202 (CPT; descriptor licensed by AMA)1
99203 (CPT; descriptor licensed by AMA)1
99204 (CPT; descriptor licensed by AMA)1
99205 (CPT; descriptor licensed by AMA)1
99211 (CPT; descriptor licensed by AMA)1
99212 (CPT; descriptor licensed by AMA)1
99213 (CPT; descriptor licensed by AMA)1
99214 (CPT; descriptor licensed by AMA)1

In the hospital outpatient PTP file v323r0, Q0091 is the column-2 (bundled) code in 1 active pair, 0% of which allow a modifier and the column-1 code in 80 (100% modifier-allowed); 110 earlier pairs have been deleted. CMS's most frequent rationale for the bundled pairs: Misuse of Column Two code with Column One code.

Column-1 codes most often paired with Q0091 (hospital outpatient)
Column-1 codePairs
G0337 Hospice evaluation preelecti1
Column-2 codes bundled into Q0091 (hospital outpatient)
Column-2 codePairs
99202 (CPT; descriptor licensed by AMA)1
99203 (CPT; descriptor licensed by AMA)1
99204 (CPT; descriptor licensed by AMA)1
99205 (CPT; descriptor licensed by AMA)1
99211 (CPT; descriptor licensed by AMA)1
99212 (CPT; descriptor licensed by AMA)1
99213 (CPT; descriptor licensed by AMA)1
99214 (CPT; descriptor licensed by AMA)1

Q0091 is a designated primary code for 1 add-on code (G0513).

Pair counts show exposure, not the answer for one claim. Check Q0091 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for Q0091

No current LCD or billing and coding article lists Q0091. The HCPCS coverage code D means special coverage instructions apply, and any National Coverage Determination for the service still applies.

Denials to expect on Q0091

CARC 50 · N115

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

CARC 151 · N362

units of Q0091 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 information needed to adjudicate the line, such as an order, NPI or required modifier

Where QuickIntell fits for Q0091 claims

QuickCode supports qualified coder review of units, modifiers and NCCI pairs for Q0091 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 Q0091

What does HCPCS code Q0091 describe?

"Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory" (short descriptor "Obtaining screen pap smear"), in the Q section (temporary codes). Added 1992-01-01; last action N (no maintenance) effective 1996-07-01.

Is Q0091 a CPT code?

No: CMS maintains Q0091 in HCPCS Level II, while the AMA maintains CPT. People do search "Q0091 CPT code", and it goes in the same procedure-code field.

What does Medicare pay for Q0091?

Medicare's October 2026 physician fee schedule pays Q0091 $46.09 non-facility and $15.70 facility nationally, from 0.36 work, 0.99 practice-expense and 0.03 malpractice RVUs at the $33.4009 conversion factor. Qualifying APM participants get $46.32 at $33.5675.

Is Q0091 an add-on code?

Q0091 is a primary code for 1 add-on code (G0513).

How many units of Q0091 can be billed per day?

MUE limits for Q0091: practitioner 1 (MAI 3, Anatomic Consideration); hospital outpatient 1 (MAI 3, Anatomic Consideration); DME supplier 0 (MAI 3, CMS Policy). 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 Q0091?

Q0091 appears in no active LCD or billing and coding article, so coverage follows HCPCS coverage code D (special coverage instructions apply) and any NCD.

CMS guidance

The Medicare Learning Network publication that CMS issues on this topic, cited by ICN and publication date:

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.