Does 0333T require prior authorization?

No, 0333T does not require prior authorization (high confidence). Code is covered without prior authorization.

What is the Medicare reimbursement rate for 0333T?

Medicare facility rate: N/A. Non-facility rate: N/A. Work RVU: 0.00.

HCPCS/CPT

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Work RVU

0.00

Facility

N/A

Non-Facility

N/A

When a referring/ordering physician is required, the name and NPI of the referring/ordering physician must be reported on the claim.
The diagnosis code(s) submitted must accurately and specifically describe the patient's condition for which the visual electrophysiology test was performed.
Follow applicable NCCI and OPPS billing requirements and edits prior to claim submission as coding may be affected by these edits.
Medical record documentation must demonstrate that VEP/VER is being used when clinical criteria (e.g., for multiple sclerosis) are inconclusive and justify the need for the test.

VEP/VER is covered to confirm the diagnosis of multiple sclerosis when clinical diagnostic criteria are inconclusive.
VEP/VER is covered to evaluate diseases of the optic nerve including optic neuritis, ischemic optic neuropathy, toxic amblyopia, nutritional amblyopia, neoplasm compressing anterior visual pathways, optic nerve injury, or optic atrophy.
VEP/VER is covered to evaluate suspected malingering or functional vision loss to help rule out nonorganic vision loss.
VEP/VER is covered for intraoperative monitoring of the visual system during optic nerve or related surgery (monitoring of short-latency evoked potentials).
Full-field electroretinography (ERG) is covered to detect loss of retinal function or to distinguish retinal lesions from optic nerve lesions.
ERG is covered for toxic retinopathies, including toxicity from intraocular metallic foreign bodies and vigabatrin exposure.

A57060 — Billing and Coding: Visual Electrophysiology Testing

J06

L36831 — Visual Electrophysiology Testing

J06

AMBETTER-CP.MP.134 — Evoked Potential Testing

Ask Verity about documentation requirements, denial risks, or coverage in your state.