Does 44212 require prior authorization?

No, 44212 does not require prior authorization (high confidence). Code is covered without prior authorization.

What is the Medicare reimbursement rate for 44212?

Medicare facility rate: $1862.10. Non-facility rate: $1862.10. Work RVU: 33.72.

HCPCS/CPT

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Work RVU

33.72

Facility

$1862.10

Non-Facility

$1862.10

No specific documentation requirements or required medical records/test results are specified in this CPB. (The policy primarily identifies tests/procedures considered obsolete/not covered and lists associated CPT/HCPCS/ICD-10 codes.)

None specified. This Clinical Policy Bulletin addresses obsolete and unreliable tests and procedures and lists tests/procedures that Aetna considers experimental and investigational (i.e., not covered).

AETNA-CPB-0438 — Obsolete and Unreliable Tests and Procedures

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