State applicability unverified · Original Medicare — reference context only
Does this service require prior authorization?
Check a procedure against payer policies. Review the source and verification date before acting.
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An answer needs a matching policy, an applicable plan and a verified source. Unconfirmed requirements are identified explicitly.
Official CMS administrative facts, HCPCS-II list references and NCD metadata are available. Clinical code-to-rule decisions are not included. CMS coverage is not an authorization decision.
Review data coverage and methodologyOfficial payer resources
All referencesState applicability unverified · Original Medicare — reference context only
State applicability unverified · Original Medicare — reference context only
State applicability unverified · Original Medicare — reference context only
State applicability unverified · Plan applicability not assessed
State applicability unverified · Plan applicability not assessed
State applicability unverified · Plan applicability not assessed
State applicability unverified · Plan applicability not assessed
State applicability unverified · Plan applicability not assessed
State applicability unverified · Original Medicare — reference context only
State applicability unverified · Original Medicare — reference context only
State applicability unverified · Original Medicare — reference context only