Quantitative imaging has rapidly become an integral component of clinical care—supporting earlier diagnosis, objective tracking, and improved confidence in interpretation. Our recent reimbursement webinar walked through best practices for billing, coding, and securing payment for NeuroQuant and OnQ Prostate, helping providers streamline claims and reduce payer friction. Below we review key takeaways for the webinar.
Category III CPT Codes: The Foundation of Reimbursement
For quantitative MRI post-processing, providers must bill the specific Category III CPT codes that describe the service performed:
NeuroQuant®
- 0865T – Quantitative brain MRI analysis without same-day diagnostic MRI
- +0866T – Add-on code when completed with a same-day diagnostic MRI
OnQ Prostate™
- 0648T – Quantitative tissue analysis (single organ) without same-day diagnostic MRI
- +0649T – Add-on with same-day diagnostic MRI
These codes are active, reimbursable, and payable across physician offices, IDTFs, freestanding imaging centers, and hospital outpatient departments.
Coverage Landscape: Positive Momentum Across Payers
Commercial Payers
Many commercial insurers have now added Category III quantitative imaging codes to their covered services lists. The webinar highlighted a real-world example, which includes these codes for Commercial and Medicare Advantage plans.
Medicare
In the absence of a published policy, Medicare contractors can approve payment when services are “reasonable and necessary.”. Submitting claims helps establish local precedent and encourages future fee schedule assignment.
Prior Authorization: When You Need It and What to Include
Traditional Medicare generally does not require prior authorization. Commercial plans typically do.
A strong prior auth request should include:
- Clear diagnosis and clinical history
- Rationale for quantitative analysis
- Relevant imaging reports and prior exams
- Peer-reviewed evidence supporting the indication
- Procedure description and site of service
Documentation Tips to Strengthen Claims
NeuroQuant
Report should state:
- Automated volumetric analysis performed
- Comparison to normative data or prior scans
- Volumes or changes integrated into interpretation
OnQ Prostate
Report should reference:
- Quantitative RSI metrics
- Regions of interest and their values
- How quantitative output informed diagnostic impression
Clear documentation improves reimbursement and audit readiness.
Final Takeaway
Reimbursement for quantitative imaging is achievable and increasingly common but requires the right coding, documentation, and workflow steps. With established APC payment, strong commercial adoption, and growing claim success, practices that follow the guidance reviewed in the webinar position themselves for reliable reimbursement moving forward.
For personalized support, help navigating an appeal, or to get access to our reimbursement webinar, please contact: reimbursementsupport@cortechs.ai.
