Does 15261 require prior authorization?

No, 15261 does not require prior authorization (high confidence). Code is covered without prior authorization.

What is the Medicare reimbursement rate for 15261?

Medicare facility rate: $112.56. Non-facility rate: $207.75. Work RVU: 2.17.

HCPCS/CPT

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Work RVU

2.17

Facility

$112.56

Non-Facility

$207.75

Report confidence intervals and/or p-values for outcome measures.
Calculate and report comparative treatment effects between groups.
Use statistical methods appropriate to the outcome type (continuous, binary, time-to-event) and account for multiple observations per patient when present.
Clinical documentation correlating the chosen laser/IPL therapy with the patient’s specific rosacea clinical manifestations at the time of presentation.

Vascular lasers and light-based devices (including intense pulsed light) for treatment/removal of telangiectasia in rosacea.
Use of laser or light-based therapy to reduce facial redness/erythema and telangiectasia associated with rosacea.
Use of laser or light-based therapy to reduce pain and improve patient satisfaction and quality of life related to rosacea symptoms.
Treatment of rosacea using nonpharmacologic modalities such as laser therapies and intense pulsed light (IPL).
Combination therapy of nonpharmacologic modalities with pharmacologic treatments for rosacea (evaluated in RCTs).
Treatment of facial erythema

BCBSIL-THE801.030 — Nonpharmacologic Treatment of Rosacea

BCBSMT-THE801.030 — Nonpharmacologic Treatment of Rosacea

BCBSNM-THE801.030 — Nonpharmacologic Treatment of Rosacea

BCBSOK-THE801.030 — Nonpharmacologic Treatment of Rosacea

THE801.030 — Nonpharmacologic Treatment of Rosacea

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