Magnetic Resonance Imaging (MRI) has revolutionized modern diagnostics, but its application becomes significantly more complex when scanning patients with implants or foreign bodies. Cases involving pacemakers, cochlear implants, abandoned leads, or retained fragments require extra safety precautions and specialized assessments that go far beyond routine screening. This critical work demands additional time and expertise from radiologists, technologists, medical physicists, and other qualified healthcare professionals (QHPs).
In recognition of these efforts, the American Medical Association (AMA) introduced six new CPT® codes for 2025 (76014-76019), specifically designed to allow providers to capture and bill for this essential safety work. This guide offers a comprehensive breakdown of what these codes are, when to use them, essential documentation requirements, and billing best practices to help radiology practices maximize compliance, enhance patient safety, and secure fair reimbursement.
What Are the 2025 MRI Safety Codes?
The new codes, officially titled “Magnetic Resonance Safety Implant/Foreign Body Procedures,” are designed for non-routine MR safety work. It is critical to distinguish these billing codes from the traditional ASTM F2503 safety labels (MR Safe, MR Conditional, MR Unsafe) found on devices. While ASTM labels indicate a device’s basic compatibility with the MR environment, the CPT codes reimburse the clinical assessment, planning, and procedural customization required to scan a patient with such a device safely.
Overview of the 2025 MRI Safety CPT® Codes
The six new codes are divided into two categories: those for pre-MRI planning and those for hands-on services performed on the day of the exam. The following table combines key details, including descriptions, timing, billing components, and estimated 2025 Medicare reimbursement figures.
| CPT® Code | Description | Timing & Component | Key Components & Use Cases | Billing & Reimbursement Notes* |
|---|---|---|---|---|
| 76014 | MR safety implant/foreign body assessment (initial 15 minutes by clinical staff) | Pre-MRI (prior date); Technical Only | Identification and verification of device, reviewing manufacturer conditions, providing patient instructions, and documentation. | G: 0.33 RVU; Approx. $10.67. Billable after 8+ minutes of work. |
| 76015 (Add-on) | Each additional 30 minutes of assessment | Pre-MRI; Technical Only | For complex cases with multiple implants or poor documentation requiring extended research. | G: 1.59 RVU; Approx. $51.43. Report up to 3 times per encounter. Each unit requires 16+ additional minutes. |
| 76016 | MR safety determination by physician/QHP | Pre-MRI; Professional Component | Risk-benefit analysis, consultation with a medical physicist, and creation of a formal written report with recommendations. | G: 2.20 / PC: 0.84 RVU; Approx. $71.16 / $27.17. |
| 76017 | MR safety medical physics exam customization | Day of MRI; Global (Physician + Tech) | Scanner adjustments (e.g., limiting SAR), sequence modification to reduce risks, and real-time monitoring. | G: 6.79 / PC: 1.07 RVU; Approx. $219.63 / $34.61. Modular; can be billed with 76018/76019. |
| 76018 | MR safety implant electronics preparation | Day of MRI; Global | Programming an active device (e.g., pacemaker, neurostimulator) to a dedicated MRI-safe mode within the MR suite. | G: 3.45 / PC: 1.05 RVU; Approx. $111.60 / $33.96. |
| 76019 | MR safety implant positioning/immobilization | Day of MRI; Global | Physically securing a device per manufacturer instructions, such as using compression bandaging on a cochlear implant. | G: 4.50 / PC: 0.83 RVU; Approx. $145.56 / $26.85. |
*RVUs are approximate and based on the 2025 Medicare Physician Fee Schedule (MPFS) with a conversion factor of $32.3465. Actual reimbursement may vary.
When to Report MRI Safety Codes
These codes should be used only for extra work that goes beyond standard screening procedures, which are already bundled into the base MRI CPT codes. Do not use them for routine questionnaires or for scanning patients with common MR Conditional devices that have clear protocols not requiring extra effort.
Trigger scenarios for these codes include:
- Patients with unlabeled, abandoned, fragmented, or legacy devices (e.g., frayed leads).
- Complex cases involving multiple implants that require verification through manufacturer registries or extensive documentation review.
- MR Conditional devices that necessitate specific actions like SAR limit adjustments, device reprogramming, or special immobilization.
- The presence of foreign bodies, such as ballistic fragments or shrapnel, near vital anatomical structures.
Step-by-Step: How to Report Each Code
Pre-MRI Planning Codes: 76014–76016
These codes are for work performed days or weeks before the scan.
- 76014: Bill for the initial 15 minutes of clinical staff time spent on device identification, reviewing MR conditions, and documenting findings. This is billable after at least 8 minutes of work.
- 76015: Use this add-on code for each additional 30-minute block of complex assessment work (e.g., a 50-minute search for records of multiple implants would be reported as 76014 + 76015 x1).
- 76016: Apply when a physician or QHP must intervene to make a safety determination, especially for ambiguous cases like abandoned leads. This service requires a distinct written report detailing the risk-benefit analysis and final recommendations.
Day-of-Exam Codes: 76017–76019
These codes capture hands-on safety measures taken during the MRI appointment.
- 76017: Report for medical physics customization, such as adjusting RF limits or scanner sequences to mitigate risks like heating.
- 76018: Use for the preparation of implantable electronics, most commonly programming a device like a pacemaker or spinal cord stimulator into its MRI mode and restoring it afterward.
- 76019: Bill for the physical positioning or immobilization of an implant, such as wrapping a cochlear implant with a compression bandage to prevent movement.
These three codes are modular and can be billed together on the same day if multiple distinct services are performed (e.g., a patient requires both device programming (76018) and physics customization (76017)).
Essential Documentation to Avoid Denials
Proper documentation is crucial, as routine chart notes are insufficient for reimbursement. All services must be thoroughly documented in the medical record.
- Time-based Codes (76014/76015): Documentation must include the exact start and end times or total minutes spent, a description of the tasks performed, and the signature of the clinical staff member.
- Physician/QHP-led Codes (76016-76019): The record must contain detailed notes on the risk analysis, specific mitigation strategies employed, physician oversight, and any informed consent discussions. For 76016, a separate, formal written report is mandatory.
- Best Practice: Utilize standardized templates (such as those inspired by the ACR) to consistently capture the device model, serial number, SAR/gradient limits, pre- and post-scan device checks, and actions taken.
Billing Guidelines and Reimbursement Tips
- Report Only Extra Work: These codes are not for routine screening.
- Timing is Key: Use 76014–76016 for services on a date prior to the MRI and 76017–76019 for services on the same date as the MRI.
- Payer Variations: Medicare began reimbursing these codes on January 1, 2025, but commercial payer policies will vary. Always verify coverage with individual insurers.
- Avoid Common Pitfalls: Common denial reasons include billing for routine screens, providing incomplete documentation, or exceeding the 3-unit limit for code 76015.
Real-World Examples
- Complex Pre-Planning: A patient has fragmented, abandoned pacemaker leads. The technologist spends 70 minutes researching the device and potential risks (report 76014 + 76015 x2), followed by a physician risk assessment and written report to clear the patient for the scan with specific limitations (report 76016).
- Day-of Adjustments: A patient with a deep brain stimulator (DBS) requires the physicist to customize scanner parameters to stay within safety limits (76017) and a qualified provider to program the device into MRI mode before the scan (76018).
- Immobilization Case: A patient with a cochlear implant needs the device to be carefully wrapped with a compression bandage according to manufacturer guidelines to proceed with the scan (76019).
Frequently Asked Questions (FAQs)
A: Yes, the pre-MRI planning codes (76014-76016) can be reported for the assessment work performed, even if a decision is made not to proceed with the scan.
A: The ASTM labels guide the assessment. For example, an “MR Conditional” device is the most common reason for needing to perform the work described by codes 76017, 76018, or 76019. The codes bill for the work of meeting those conditions, not the label itself.
A: By stacking multiple codes appropriately (e.g., pre-planning followed by several day-of services), reimbursement for a single complex patient encounter could exceed $500.
Final Tips for Success
The 2025 MRI safety codes represent a significant advancement in recognizing the specialized expertise required to safely scan patients with implants. To succeed, practices should integrate these codes into their workflows with thoughtful staff training and a strong emphasis on detailed documentation. Doing so will not only support practice revenue but, more importantly, enhance patient care and safety in an evolving area of radiology.
For specific or complex cases, always consult the latest AMA CPT® guidelines and the ACR Manual on MR Safety.