59025 Antepartum testing

CPT 59025

CPT 59025: Fetal Non-Stress Test (NST)Fetal Non-Stress Test (NST)

The short answer

Use 59025 for a fetal non-stress test: monitoring fetal heart rate against fetal movement to assess well-being, with a physician interpretation. It bills separately from the global OB package when a medical indication is documented. Routine monitoring during a standard visit, or the strip run during labor, is not an NST.

Source: NCCISource: CMS MPFS 2026Source: ACOG

When to use 59025

Report 59025 when a distinct, medically indicated non-stress test is ordered, performed, and interpreted: think decreased fetal movement, post-dates surveillance, or twice-weekly testing for conditions like gestational diabetes or hypertension. The service needs its own indication, tracing, and signed interpretation. It is not billable for incidental heart-rate checks during a routine antepartum visit or for continuous monitoring during labor.

When 59025 is billable vs not

59025 · Billable NST

Ordered for a documented indication
Dedicated tracing with fetal movement correlation
Signed interpretation and report
Serial surveillance schedules (each test billable)

Not an NST

Heart tones checked at a routine visit
Monitoring strip during labor and delivery
Biophysical profile performed (bill 76818/76819 instead)
No interpretation on file

Documentation checklist

NST denials are documentation denials. The record needs to show the test was indicated, performed as a distinct service, and interpreted.

✓ Medical indication documented (decreased movement, post-dates, diabetes, hypertension)

✓ Tracing of adequate duration with fetal movement noted

✓ Reactive or non-reactive result recorded

✓ Signed physician or qualified provider interpretation

✓ Order for serial testing frequency when applicable

✓ Separate documentation from the routine visit note when done same day

Global package rules

The non-stress test is not part of the global obstetric package. 59025 bills separately from 59400 each time a medically indicated test is performed, including serial surveillance schedules. When an NST is done the same day as a routine antepartum visit, keep the documentation distinct; the visit stays global while the NST bills on its own. NCCI

TC-26 components

Like imaging codes, the NST splits into components. The practice that owns the monitor bills the technical component; the interpreting provider bills professional. One entity doing both bills global.

59025

Global — one entity runs the test and interprets

59025-26

Professional — interpretation only

59025-TC

Technical — equipment and staff

Reimbursement

2026 · national Medicare averages

Component	Work RVU	Total RVU	2026 rate
59025Global	0.52	1.51	$50.44
59025-26Professional	0.52	0.88	$29.39
59025-TCTechnical	0.00	0.63	$21.04

National amounts under the 2026 Medicare Physician Fee Schedule (non-facility total RVU x $33.4009 conversion factor, no locality/MAC adjustment). Commercial and Medicaid rates differ. Verify current values with your MAC before billing.

Common denials

CO-97 NST bundled into the global package or visit

Why it happens

The payer treated the NST as part of routine antepartum care or a same-day E/M visit.

How to fix

Appeal with the distinct indication and the separate tracing and interpretation. The NST is not a bundled service under the global package; cite the NCCI guidance.

Source: NCCI

CO-50 Not medically necessary

Why it happens

No indication was linked, or the diagnosis submitted does not support fetal surveillance.

How to fix

Link the surveillance indication (decreased movement, post-dates, diabetes, hypertension) as the primary diagnosis and resubmit.

Source: ACOG

CO-151 Frequency exceeded

Why it happens

Serial NSTs hit the payer's frequency ceiling without documentation of the surveillance schedule.

How to fix

Submit the standing order with the indicated frequency (for example, twice weekly for the stated condition) and the individual interpretations.

Source: CMS

CO-16 Missing TC/26 split

Why it happens

Two entities each billed the full global code, or components were billed without modifiers.

How to fix

Bill 59025-26 for interpretation only and 59025-TC for the technical service; only one entity bills the unmodified global code.

Source: CMS

FAQ

What is the CPT code description for 59025?

In plain language, 59025 covers the fetal non-stress test: monitoring the fetal heart rate over a dedicated tracing, correlating accelerations with fetal movement, and producing an interpreted result (reactive or non-reactive).

Is an NST included in the global OB package?

No. Each medically indicated NST bills separately from the global package, including tests in a serial surveillance schedule.

Can I bill 59025 with a same-day office visit?

Yes, when the visit is a routine global visit the NST still bills on its own. If a separate problem E/M is billed the same day, append modifier 25 to the E/M and keep documentation distinct.

How is an NST different from a biophysical profile?

The BPP adds ultrasound assessment of fetal breathing, movement, tone, and fluid to the heart-rate testing. Bill 76818 (with NST) or 76819 (without) for a BPP rather than stacking codes.

For twins, do I bill 59025 twice?

Payer rules vary. Many accept 59025 per fetus with modifier 59 or XS on the second, each with its own tracing and interpretation. Confirm the payer's multiple-gestation policy.

CPT® is a registered trademark of the American Medical Association. Educational reference only, not billing, legal, or medical advice. Maintained by Ouma Health, a maternal-fetal telemedicine practice. Printed from obcodingguide.com, content current as of July 2026.