Does 33980 require prior authorization?

No, 33980 does not require prior authorization (high confidence). Code is covered without prior authorization.

What is the Medicare reimbursement rate for 33980?

Medicare facility rate: $1636.31. Non-facility rate: $1636.31. Work RVU: 32.66.

HCPCS/CPT

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Work RVU

32.66

Facility

$1636.31

Non-Facility

$1636.31

No explicit documentation requirements (medical records, test results, or clinical documentation) are provided in the supplied document text.
Refer to Medicare Benefit Policy Manual, Chapter 15, §120 Prosthetic Devices for relevant documentation guidance.
Refer to full texts of NCD 260.9 (Heart Transplants), NCD 310.1 (Routine Costs in Clinical Trials), and NCD 20.9.1 (Ventricular Assist Devices) for required documentation elements.
Refer to full LCA articles A59657, A59658, A53988, A53986 for specific documentation requirements — none are specified in this excerpt.

Q0486: Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only
Q0508 | Miscellaneous supply or accessory for use with an implanted ventricular assist device
Advanced heart failure (HF) unmanageable with optimal medical and device-based therapies
Use of mechanical circulatory support (MCS) from a ventricular assist device (VAD) or total artificial heart (TAH) as a treatment option
Short-term mechanical circulatory support
Long-term mechanical circulatory support

AMBETTER-CP.MP.46 — Ventricular Assist Devices

HUMANA-VENTRICULAR-ASSIST-DEVICE-TOTAL-ARTIFICIAL-HEART-MA — Ventricular Assist Device, Total Artificial Heart - Medicare Advantage

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