P9100 — Pathogen(s) test for platelets
P9100 is a HCPCS Level II code for pathogen(s) test for platelets. It belongs to the Pathology and Laboratory Services section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Special coverage instructions apply
There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusX
Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
Medically Unlikely Edits — units per day
The most units of P9100 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 2 units MAI 3 — Date of Service Edit: Clinical · Clinical: CMS Workgroup
- outpatient
- 12 units MAI 3 — Date of Service Edit: Clinical · Clinical: CMS Workgroup
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for P9100
- Long descriptor
- Pathogen(s) test for platelets
- Short descriptor
- Pathogen test for platelets
- Added
- January 1, 2018
- BETOS
- T1H
- Pricing indicator
- 57 — Other
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Other carrier priced.
Codes adjacent to P9100
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If P9100 is not quite right, the correct code is very often within a few positions of it.
- P9058Red blood cells, leukocytes reduced, cmv-negative, irradiated, each unit
- P9059Fresh frozen plasma between 8-24 hours of collection, each unit
- P9060Fresh frozen plasma, donor retested, each unit
- P9070Plasma, pooled multiple donor, pathogen reduced, frozen, each unit
- P9071Plasma (single donor), pathogen reduced, frozen, each unit
- P9072Platelets, pheresis, pathogen reduced or rapid bacterial tested, each unitterminated
- P9073Platelets, pheresis, pathogen-reduced, each unit
- P9099Blood component or product not otherwise classified
- P9603Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled
- P9604Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge
- P9612Catheterization for collection of specimen, single patient, all places of service
- P9615Catheterization for collection of specimen(s) (multiple patients)
- Q0035Cardiokymography
- Q0081Infusion therapy, using other than chemotherapeutic drugs, per visit
- Q0083Chemotherapy administration by other than infusion technique only (e.g., subcutaneous, intramuscular, push), per visit
- Q0084Chemotherapy administration by infusion technique only, per visit
Questions about P9100
What is HCPCS code P9100?
P9100 is a HCPCS Level II code for pathogen(s) test for platelets. It sits in the Pathology and Laboratory Services section.
Does Medicare cover P9100?
The CMS HCPCS file marks P9100 as "Special coverage instructions apply". There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
How is P9100 paid under the physician fee schedule?
P9100 carries PFS status code X. Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.