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December 2016 Texas Medicaid Provider Procedures Manual

Radiology and Laboratory Services Handbook : 3 Radiological and physiological laboratory services : 3.2 Services, Benefits, Limitations, and Prior Authorization : 3.2.3 Positron Emission Tomography (PET) Scan Imaging

PET scan imaging services are benefits of Texas Medicaid and may be reimbursed using the following procedure codes:
Procedure codes 78459, 78491, and 78492 are not reimbursed by Texas Medicaid.
The PET scan procedure may be reimbursed separately from the diagnostic radiopharmaceutical.
Refer to:
The online fee lookup (OFL) or the applicable fee schedules on the TMHP website at to review the diagnostic radiopharmaceuticals that are reimbursed by Texas Medicaid.

Texas Medicaid & Healthcare Partnership
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