International Forestry Review Vol.11(1), 2009
Uganda's Sawlog Production Grant Scheme:a success story from Africa
SPGS, P.O. Box 5244, Kampala, Uganda
The Sawlog Production Grant Scheme (SPGS) has supported private sector tree planting in Uganda since 2004. The project has been the catalyst for attracting substantial investment into timber plantations from small-medium local growers to large foreign investors. Over 10,000 hectares have been already established with huge interest to do much more. Many rural jobs are being created and the foundations are being laid for a sustainable, commercial forest industry in Uganda. The SPGS has evolved into a robust model that successfully engages private growers: and this is in a country where tree planting on a commercial scale was always considered the State's business. The background and modus operandi of the project are detailed in this article as well as the challenges encountered. With the project creating considerable interest from other countries, the key elements that have contributed to making the SPGS a success are discussed to encourage its replication elsewhere.
Keywords: SPGS, Uganda forestry, timber plantations, grant scheme, private sector
Projet d'aide à la production de rondins en Uganda: histoire d'un succès venant d'Afrique
Le projet d'aide à la production de bûches (SPGS) soutient un secteur privé de plantation d'arbres en Uganda depuis 2004. Le projet a été un catalyseur attirant un investissement substantiel dans les plantations de bois passant de planteurs locaux petits et moyens a de larges investisseurs étrangers. Plus de 10 000 hectares ont été déjà établis, et il existe un intérêt très fort d'en faire davantage. Beaucoup d'emplois ruraux sont crées, et les fondations pour une foresterie industrielle durable sont posées en Uganda. Le SPGS a évolué pour devenir un modèle robuste qui engage les producteurs privés avec succès, et cela, dans un pays où la plantation d'arbres à l'échelle commerciale était toujours considéré comme une affaire dont l'état devait s'occuper. L'origine et le mode opérationnel du projet sont détaillés dans cet article, ainsi que les défi s qu'il a rencontré. En se souvenant que ce projet suscite un intérêt considérable dans d'autres pays, les éléments clés ayant contribué au succès du SPGS sont examinés pour encourager sa reproduction ailleurs.
Programa de Subsidios para la Producción de Maderos: un éxito ejemplar en África
El Programa de Subsidios para la Producción de Maderos (SPGS) ha apoyado la plantación de árboles por parte del sector privado en Uganda desde el año 2004. El proyecto ha servido de catalizador para atraer inversiones importantes en plantaciones de madera, de cultivadores locales de escala pequeña y mediana hasta grandes inversionistas extranjeros. Ya se ha plantado más de 10 000 hectáreas, y existe mucho interés en extender el programa. Se está creando mucho empleo en zonas rurales, y se está estableciendo los fundamentos para una industria forestal comercial y sostenible en Uganda. El SPGS ha llegado a ser un modelo robusto que atrae con éxito a los cultivadores del sector privado, y esto se ha logrado en un país donde la plantación de árboles en escala comercial se había considerado hasta ahora trabajo del estado. Los antecedentes y el modus operandi del proyecto se describen en este artículo, además de los desafíos que se ha tenido que afrontar. El proyecto ha suscitado un gran interés en otros países, y se analizan los elementos clave que han contribuido al éxito del SPGS con el fi n de promover su duplicación en otros lugares.
European Union (EU) and Government of Uganda project that offi cially started in 2004, though it was a few years in the
Uganda's Sawlog Production Grant Scheme (SPGS) does
planning phase prior to that. In just four years, over 10,000
what you might expect: it gives grants to people establishing
hectares (ha) have been established by private growers (both
tree plantations primarily for timber production. It is a joint
large and small scale) and the demand has been created
to multiply this many times over. The project has not just
phenomenal growth rates achievable in many parts of the
stimulated the planting of timber crops throughout the
country. The combination of a bimodal rainfall pattern and
country but has kick-started the development of many areas
generally fertile soils in many areas, results in some Mean
which are essential to support the emerging sector - especially
Annual Increments (MAIs) that many visiting foresters
commercial forestry research, training and larger nurseries.
cannot believe. On good sites MAIs of 60 and 30 m3/ha/yr
In doing this many thousands of rural jobs are being created,
are possible with Eucalyptus grandis and Pinus caribaea
both directly in plantation establishment and maintenance
respectively. Of course, this is only the case where the
and indirectly in the support services mentioned.
right silvicultural techniques are applied - especially good
In a country with massive rural poverty and rampant
weed control and the use of improved genetic material. In
deforestation, the SPGS is proving to be a winning formula.
a country where there had been virtually no planting for 35
It is also attracting substantial private investment into the
years this presents quite a challenge, with little experience of
sector, from both within and beyond Uganda's borders. The
many 'modern' commercial plantation practices.
project is poised to receive substantial further support from both the EU and the Norwegian Government from mid-2009 to 2013. It is not really surprisingly, therefore, that many
other countries in the region are now asking how the SPGS is achieving such results within a modest budget (ca.US$5.5M
The reform process in Uganda's forest sector has been
to date). This article describes briefl y how the project works
written about exhaustively in Turyahabwe and Banana
but focuses more on what the author considers are the key
(2008) so here I offer a more personal view on the process
reasons for its success. Whilst every country (even within
and highlight where it has impacted on tree planting and on
Africa) is different, the SPGS has developed a model which
could be transplanted to other countries provided some of
The weaknesses of the UFD became clear in the 1990's,
the fundamental issues described here are taken on board.
with rampant deforestation and many failed initiatives to expand the plantation resource. The Government of Uganda (GoU) and the donors who had supported the UFD for many
years (notably EU and Norway) called time and insisted on a reform of the whole forest sector if they were to continue
Before describing the modus operandi of the SPGS it is
their funding. By 2004 - a long fi ve years after the reform
important to understand the background situation in the
process began (funded largely by the UK's DFID) - the
country. Around 20% of Uganda's land area is classifi ed as
UFD was axed and a new, semi-autonomous National Forest
forest, though the majority of this is woodland. The forest
Authority (NFA) created. Additionally, a District Forest
that remains is severely threatened largely from clearance
Service (DFS) and a GoU watch-dog - the Forest Sector
for agriculture (subsistence and commercial) and charcoal
Support Division (FSSD) - were also created.
production (>90% of Ugandan's depend on wood for
The NFA's core role is to manage the country's 1.2M ha of
energy). A recent study showed that Uganda lost 92,000 ha
Central Forest Reserves (CFRs). There are 506 CFRs across
of forest in 2007 alone. The country's economy is growing
the country, ranging from Tropical High Forest (including
fast (albeit from a low base) and this, coupled with a very
the famous Budongo and Mabira Forests) to highly degraded
high population growth rate (3.4%) is creating a demand for
or sparsely wooded areas suitable for commercial planting.
timber predicted to be 1M m3 per year by 2025. There are
Long-term tree-planting licenses (permits) are being made
also fast developing markets in neighbouring countries -
available to private investors in some of these CFRs. The
notably Rwanda, Kenya and Southern Sudan.
NFA has planted ca.5,000 ha itself since 2004 and has
Despite the Ugandan Forest Dept.'s (UFD) warning-bells
plans to establish up to 50,000 ha if it can source suffi cient
that started ringing well over 50 years ago, the country is
funding. The NFA also has commercial nurseries and offers
now in dire straits with regard to timber plantations. The
private growers other services such as mapping and writing
plantation establishment efforts of the late 1960's and early
'70's (when some 15,000 ha of pine was planted) were unfortunately never built on. These over-mature plantations are now almost fi nished (<1,000 ha left) and the sad fact
is that serious new planting (or replanting) only started around fi ve years ago, with the EU support to the UFD. The
The idea of a Plantation Fund (which evolved into the
generally accepted target for Uganda is 150,000 ha of timber
SPGS) to attract the private sector interest into commercial
plantations by 2020 - the bulk of which will be established
tree planting, was originally part of a larger EU initiative
by the private sector. There are currently only around 20,000
- the Forest Resources Management and Conservation
ha of plantations countrywide, and >80% of these are under
Programme (FRMCP). The FRMCP was a 5-year, €12M
fi ve years old. Whilst this scenario is worrying at a national
programme which started in 2002. It was the culmination
level, however, it is a great opportunity for those investing in
of over 10 years of EU support to the Ugandan forest sector,
all of which had been directed at conservation of those
One of Uganda's USPs (Unique Selling Points) is the
CFRs considered to be biodiversity 'hot-spots'. For the
Uganda's Sawlog Production Grant Scheme
fi rst time, however, the important link between plantations
protection from livestock and fi res etc.
and conservation was made and the FRMCP included a
• The project's support period covers the fi rst two years
component of ca.€2M for 'compensatory timber plantations'
to be established by the private sector.
• The grant is set at a fi xed rate countrywide
It took nearly two years to come up with the right formula
(UGX600,000 - ca.US$350 - per ha).
for the SPGS: after the inevitable stakeholder workshops and
• The rate was calculated at 50% of the average full
much deliberation, it was decided that the best approach was
conditional grants rather than loans. Initial attempts to get an
• Payment is split into three tranches over the two-year
external body to run the initiative had failed, with fi nancial
institutions nervous about commercial forestry (having no
• No grant funds are paid up-front: SPGS 'clients'
experience of it and alarmed by the time-scale). Eventually
must thus start with their own resources.
it was decided that the FRMCP should run the SPGS, under
• Payments are only made after a site inspection
the supervision of a separate Steering Committee. It took
has confi rmed the area planted and the standards
some time for people to consider investing in tree planting,
since it had always been considered the State's business.
• Technical support is largely free - in terms of advice
However, after a slow start in 2004, the interest from the
given on-site (or in the offi ce) and many useful
private sector took off exponentially, even threatening to
swamp the newly launched ship, with questions being raised in Parliament about why the project does not support more
The current SPGS team comprises a Project Manager
(a non-forester) with fi ve young forestry graduates and
The SPGS initially operated within the NFA but it was
administrative support staff. There are two long-term TAs
considered inappropriate for the organization to be also
(Technical Advisors, the author included) attached to
controlling a fund for private sector planting, especially
the project, both seasoned by many years experience of
given that they were actively seeking funds themselves to
commercial pine and eucalypt plantations in Southern and
fi nance their own commercial planting. Although the SPGS
East Africa. The young graduates had little or no experience
was always kept separate from core NFA operations, the
of commercial forestry when recruited but have been
project offi cially moved from the NFA in 2006 and was
intensively trained and 'mentored' by the TAs as well as
placed under the supervision of FSSD, within the GoU's
being exposed to the commercial forestry culture in other
Ministry of Water and Environment. In practice, however,
countries. Over a four year period, the SPGS has achieved
the SPGS team has been left to run their business, reporting
substantial results and learned some valuable lessons which
to a Steering Committee every three months, which has
will be of interest to anyone considering starting a similar
representatives of GoU, EU and the private sector.
project elsewhere. These thoughts are summarized over the following sections.
The protracted gestation period of the project turned out to be a blessing in disguise since it gave time to consult with
Ten thousand hectares of plantation have been directly
many people - from both inside and outside the country.
supported (i.e. fi nancially and technically) by the project to
When the SPGS was offi cially launched in 2004, it had clear
date (Sept 2008). Of the 10,000 ha total, 79% was planted
guidelines for potential tree growers. The main components
on public (CFR) land, 21% on private land. The breakdown
by size of planter is shown in Table 1. There has also been
• Support is only for private sector individuals,
substantial (to date not quantifi ed) private planting outside
of the SPGS and many of these have benefi ted from the
• The SPGS contracts are for a minimum 25 ha and
project's advisory and training support.
One of the interesting things about the SPGS has been the
• The land for planting can be privately owned or CFR
way it has appealed to a wide cross-section of investors.
• A formal Contract must be signed before support can
TABLE 1 Breakdown of SPGS Planters 2004-08
• The Contract must include an approved Forest
Plantation Size No. Planters Contracted (10,000ha)
• The SPGS only supports trees grown primarily for
• The Contract includes basic standards that must be
achieved - e.g. species planted as per FMP; use of
approved seed sources only; minimum 80% stocking
after three months; basic 1m diameter ring-weeding;
The project's main benefi ciaries are the small-medium
All the above publications (and Seminar proceedings) are
entrepreneurs, many of whom had no background experience
of tree growing: the SPGS incentives were enough to get them started with what they see as a good investment. The larger growers (four companies) would probably have started
planting without the project's support but the SPGS's other roles (especially technical support and general promotion of
The SPGS has always had a very commercial outlook, which
the industry) have been more important to them. These larger
is believed to be the best way to help develop a sustainable
growers are now planting beyond the SPGS supported areas.
forest industry in Uganda. It was intended from the outset,
The SPGS only funds plantations grown for timber
however, that it would be prudent to extend the project's
and/or large poles. The main species promoted are Pinus
support to some of the smaller growers in the vicinity of
caribaea var. hondurensis (PCH), Eucalyptus grandis and
the main commercial growers, thereby 'sensitizing' these
the indigenous Maesopsis eminii. Limited areas are also
communities about tree growing. For these small, community-
being planted with P. patula, Araucaria cunninghamii
based people, the project developed a different approach
and Terminalia superba and (from early 2008) Eucalyptus
than that for its main clients. Interested communities with
hybrid clones. P. oocarpa was planted at the start but the
some spare land for growing timber trees are encouraged
seed quality available in Uganda is so poor that the project
to form an Association. SPGS staff then conduct on-site
does not now promote it. Expected rotations are 18-20 years
training in the basics of tree establishment and provided
for PCH and 12-15 years for E. grandis, provided the heavy,
these community groups prepare the land adequately, the
early thinning regimes recommended by the SPGS are
project then delivers seedlings at a time coinciding with the
rains. No funds are given to the community planters - just free advice and seedlings.
The interest in this community planting initiative took us
by surprise and over 500,000 seedlings have been delivered from 2005-08. The demand is there for much more support
During the project's lifespan enormous interest has been
in the future too. Given that the people have already shown
created in growing trees for timber in Uganda. This has been
interest and put in some effort to prepare the land for planting,
achieved through numerous communication and training
it is a reasonable assumption that most of these trees were
subsequently planted out (the project is currently following
• A highly regarded, quarterly Newsletter: this is a
up on this), which adds up to a signifi cant contribution to
glossy, full colour publication used to keep people
the cause (and of course, important income for the growers
informed about the project and the sector. It is also
used as educational and motivating tool, with pictures of good and bad practices from Uganda and beyond.
• Field-based clients' meetings are organized every
three months: these have become immensely popular and a great way for people to share experiences. After
Many people have recently asked us this question and like
a full day's tour of various plantations, there is a half-
many aspects of forestry, there is not a straight answer. It is
day formal meeting always with a lively question and
down to a combination of factors many of which have been
mentioned in this article. However, it will do no harm to
• Many SPGS Plantation Guidelines have been printed
and freely disseminated: these are practical, well
• The provision of grants is an obvious attraction for
any grower but the provision of sound technical
• The project saw the need early on to provide practical
training courses aimed at the clients' supervisors and
• The project's fi eld staff must have sound experience
fi eld managers. These are mostly 4-day, residential
of commercial forestry plantations, preferably in the
courses, only partly subsided by the project and run
by the project staff: the key ones being Plantation
• Not paying any funds up-front sorts the chancers
Planning and Establishment and Plantation
from the serious planters pretty quickly.
Maintenance. All clients are strongly advised to send
• The 25-500 ha range appealed to a wide range
of investors and the smaller growers have clearly
• The project has for the last three years organized
benefi ted from the experience of the larger ones.
a national Commercial Forestry Seminar in order
• The project's many communication channels and
to raise the profi le of the business. Importing high
its fl exible attitude have been important (with a
profi le Guest Speakers has helped immensely here (in
supportive Steering Committee too). The project
2008 - John Spears, ex-World Bank Senior Forestry
initially excluded Eucalypts (thinking growers
Advisor; in 2007 - Mike Edwards, ex-ED of Forestry
would take the grant and then cut them for poles and
fi rewood); it had a 100 ha lower limit (lowered to 25
Uganda's Sawlog Production Grant Scheme
ha early on after listening to the pleas of many smaller
by-products and end-products that will be also produced.
growers) and offered growers no support beyond the
Given the history of the sector, there is currently very little in
2-year contract (small pruning and thinning grants
terms of modern processing facilities in Uganda and thus the
whole issue of timber processing and marketing will have to
• The SPGS is basically a forestry extension service:
be the focus of more attention in the near future.
but having well trained and motivated staff has made
The project has clearly raised awareness of the great
potential of commercial forestry not only as a sound
• The project setting and enforced clear standards from
investment but as a great tool for rural development. It has
the outset, despite signifi cant pressure to relax the
also left behind a permanent legacy in terms of training a
new generation of foresters - and changing people's attitudes
• A number of 'best practice' demonstration plots
from the rigid practices of the past to a more dynamic and
were established in strategic areas close to some
exciting environment that is forestry today.
of the country's main arterial roads in 2002/03. These created a huge interest within just a few years (a combination of Uganda's fast growth rates
with modern silvicultural practices not seen before certainly helped the cause). These plots are still
It will come as no surprise to hear that the recent surge of
interest in commercial tree planting in Uganda has placed a
• The project used some early successful growers as
severe strain on a range of support services in the sector, most
role models, which not only fostered a competitive
notably seed and seedling supply and the need for practical
spirit but eventually created a 'peer pressure'
research and training in commercial forestry matters. Indeed
Uganda is proving to be a fascinating case study for setting
• From the start, the approach of the project was not
up a commercial forestry industry almost from scratch.
to reinvent the wheel by trying out and adapting
For various reasons we don't have suffi cient space
appropriate practices that had been developed
to discuss, the country has lost nearly all its best genetic
successfully elsewhere. The TAs' experience and the
material, with virtually all trials and seed stands converted
trips with growers to Southern Africa helped foster
into planks. The SPGS made it clear from the start that the
vast majority of local seed was not of suffi cient quality for commercial planting. On the one hand the project was fortunate that its principle species - Pinus caribaea var.
hondurensis (PCH) - was the focus of Garth Nikle's and his team's excellent breeding programme in Queensland. Thus
The most frequent criticism leveled at the project has related
we were able to import high quality, seed orchard PCH direct
to its sustainability. Donor-funded projects invariably have
from Australia (at a price of course!). On the other hand,
a short lifespan - unlike timber trees (even with Uganda's
we have been unfortunate insofar as PCH is not a prolifi c
growth rates). This means that many potential planters have
seed producer and thus have not been able to source enough
been disappointed not to get support. The SPGS however,
improved seed (a private supplier from Brazil has kept us
developed a momentum of its own and the results along with
going). Improved E. grandis seed has also been imported
the huge private sector interest, helped persuade the donors
from South Africa, though this is also in very short supply.
and the GoU that this project was working well and needed
The nurseries in Uganda have also struggled to cope with
to be supported longer. The EU's initial funding for the two
the rapid increase in demand. There are no large, modern
year period (2004-06) was then extended by a further two
nurseries here yet (though some of the larger companies
years (2006-08) and there is now a strong likelihood of an
have plans for them) and thus the highly ineffi cient poly-
extension (and considerable expansion) up to 2013 - to be
pot and top soil system prevails. Whilst this nursery system
funded jointly by the EU and the Norwegian Government.
can produce high quality, robust plants and is certainly more
Another very important achievement has been to facilitate
forgiving than modern nurseries, as production level soar,
the formation of an independent, voluntary growers'
it requires huge quantities of soil to be moved around the
organisation - the Uganda Timber Growers Association
country. The project is looking into ways of encouraging
(UTGA). UTGA has in a very short space of time, become
private entrepreneurs to invest in improved, larger nurseries,
respected by the GoU and others as representing the private
which after all, have a much quicker pay-back than growing
growers (they already have over 60 members signed up to
date, including all the medium to large growers). UTGA will hopefully be around for a long time after the SPGS has closed.
The SPGS is aimed at helping the private sector to lead
the development of a sustainable forest industry in Uganda.
As a consequence of no new planting for the past 35 years
The focus to date has been on producing quality sawlogs
or so, there has been little commercial forestry research or
and large poles, though there will inevitably be many other
training going on in Uganda. This is clearly evident from the
lack of many silvicultural advances considered as standard
in many countries - such as 'new' species and clonal
The staff must be equipped with necessary skills to
testing, detailed site-species matching techniques, weeding
confi dently and professionally give sound advice to people:
research, spacing and thinning trials. The need for focused,
such skills do not come overnight (or from attending a short
applied research is fast becoming critical. The private sector
course on plantation forestry) so time must be allowed to
investors are increasingly worried about the lack of support
build up the team's skills. They need to be well motivated
too. The country's offi cial research and training institutions
to achieve their tasks: in this regard, the SPGS's trips with
are now under the spotlight but are generally not used to the
staff and growers to countries with a large commercial
results-orientated, demand-driven environment that is now
forestry sector (like South Africa and Swaziland) have paid
In order to stimulate some action, the SPGS has initiated
Selecting foresters based merely on their seniority from
a Steering Group called COMFORT (Commercial Forestry
Forest Departments or Authorities will not necessarily
Research and Training). This has all the key players from the
reproduce the SPGS's results in Uganda. Experience with
sector - including public institutions and private growers'
the private sector and also commercial tree plantations
representatives. Through COMFORT, the private sector
are essential: if there are few such skills in country, it
have set out their priorities and the fi rst research projects
would be wise to bring in proven private sector managers,
were funded by the SPGS in 2008 - one on pests and
supplemented with experienced forestry advisors for a period
diseases, the other a tree growth study. Another early result
to build up the skills. The SPGS's 'catch 'em young' policy
from COMFORT was fi nding fi eld placements for students
(i.e. recruiting young forestry graduates and intensively
from the local forestry college (Nyabyeya) to gain valuable
training them) is highly recommended also.
practical experience with private growers during their long
Finally, the best Eucalyptus plantations in Uganda for
vacation. Hopefully this will be the start of a major private
many years were those established by non-foresters from
sector-driven, research and training initiative that will
the mid-1990's onwards, in James Finlay's tea estates in
Western Uganda. The vast majority of the SPGS's growers are not foresters either, but entrepreneurs with land, who are eager to learn how to grow trees well. Makes one think
With the anticipated expansion of the SPGS it is a good time to refl ect on the fi rst phase and to plan carefully for the next
phase. Likely changes could be: expanding the successful community support (hopefully in partnership with selected
The SPGS management team of Allan Amumpe, Bric
community-based organisations); raising standards of
Milligan, Celia Nalwadda, Charles Odeke, Thaddeus
growers (the current SPGS is already piloting a small Group
Businge, Zainabu Kakungulu, Alex Atuyamba and
Scheme application under the Forest Stewardship Council);
Josephine Mbogga. Gershom Onyango (GoU); Cornelius
scaling up support for commercial forestry research
Kazoora (Sustainable Development Centre); EU personnel
and training facilities in the country and even bioenergy
- Otto Mőller, Christer Hermansson, Margaret Kasekende
plantations. Further efforts will also have to be made to fi nd
and Véronique Lorenzo; the initial planning team who
the most appropriate ways to get the message across to the
conceptualized the project: notably Pat Hardcastle (LTS
country's decision makers about the huge socio-economic
International), Bill Farmer (now with Uganda Carbon
potential of a sustainable forestry industry based on fast-
Bureau) and Tony Finch; David Hopkins, ex-MD of
Agrisystems Ltd. (now Cardno Agrisystems); Jossy Byamah (Busoga Forestry Co., a subsidiary of Green Resources ASA) and Brenda Mwebaze - just two of the early success
stories of the SPGS. Jossy is also the inaugural Chairman of the Uganda Timber Growers Association (UTGA); Brenda
With the best will in the world, having a solid (and
is Secretary of the Kamusiime Association in Bushenyi - the
proven) project design is only part of the battle. As with all
role model community group. The tremendous support given
successful organisations, the key lies in the management
to the SPGS by private companies and organizations in South
team. To succeed the team needs to have a results-orientated,
Africa and Swaziland over the last few years is gratefully
private sector approach to their business. This infers having
acknowledged. And fi nally to the IFR Editor, Alan Pottinger,
adequate (and timely) funds and clearly defi ned targets. The
for badgering me to write my thoughts down.
reporting systems - fi nancial and physical - must also be rigid and deadlines adhered to. Any grant scheme is open to abuse, with some people willing to 'persuade' project
staff to sign off their plantations, even though they did not make the grade. Thus checks must be built into the system -
TURYAHABWE, N. and BANANA, A.Y. 2008. An
for example, a self auditing system with random checks on
overview of the history and development of forest policy
Uganda's Sawlog Production Grant Scheme
and legislation in Uganda. International Forestry Review 10(4) 641-656.
Be Active : An Economic Appraisal April 2006 P.R. Myles Executive Summary This report is an economic appraisal of the physical activity referral programme ‘Be Active’. The aim is to determine whether the benefits of the ‘Be Active’ programme outweighed the costs. A cost-consequences analysis (CCA) has been carried out which provides detailed costing of the proj
UCLA Health System Office of Compliance and Privacy Disclaimer: Please be advised that this guideline is a compilation of information from various sources as enumerated in the reference section. While every effort has been made to ensure the accuracy of the information provided according to the most current CMS transmittals, CPT Coding Manual, CPT Changes, and CPT Assistant advices pertainin