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Category III CPT Codes
Temporary CPT codes for emerging technologies, services, and procedures.
Reviewed by Christian Espinosa, Founder, Blue Goat CyberLast reviewed May 5, 2026
Definition
Category III CPT codes (T codes) allow data collection on emerging procedures and devices. They sunset after five years unless converted to Category I, but can be extended. What the regulation says
The Centers for Medicare & Medicaid Services (CMS) and private payers use Category III CPT codes for tracking new technologies and services. While they do not assure reimbursement, these codes facilitate data collection essential for assessing efficacy and utilization, which can be a prerequisite for future coverage decisions and conversion to Category I CPT codes.
What this means in practice
Category III codes do not guarantee payment but enable claims tracking and serve as evidence for future Category I applications and coverage decisions.Examples
- A medical device company launches an innovative surgical robot, and its procedures are initially billed using Category III CPT codes to track patient outcomes and adoption.
- A hospital uses a Category III CPT code to report services for a novel diagnostic test, gathering data on its effectiveness and impact on patient care.
- A new non-invasive therapy for a chronic condition receives a Category III CPT code, allowing healthcare providers to submit claims and collect utilization data for potential future coverage.
Common pitfalls
- •A common pitfall is misunderstanding that Category III codes do not guarantee reimbursement, leading to financial planning inaccuracies for new MedTech products.
- •Another mistake is neglecting to collect robust data during the Category III period, which can hinder efforts to upgrade to Category I status.
- •Companies often fail to monitor the five-year sunset provision, risking the loss of a code before adequate data for conversion is gathered.
Frequently asked questions
The primary purpose is to allow for the tracking and data collection of new and emerging medical technologies, procedures, and services that do not yet meet the requirements for a Category I CPT code.
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Primary references
3 sourcesLink health: 3 verified· last checked 2026-06-20
AMA·2AdvaMed·1
- 1
AMA Category III CodesVerifiedAMAama-assn.org
- 2
AdvaMed - Payment & CoverageVerifiedAdvaMedadvamed.org
- 3
AMA CPT ResourcesVerifiedAMAama-assn.org
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