Does 59020 require prior authorization?

No, 59020 does not require prior authorization (high confidence). Code is covered without prior authorization.

What is the Medicare reimbursement rate for 59020?

Medicare facility rate: $72.81. Non-facility rate: $72.81. Work RVU: 0.64.

HCPCS/CPT

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Work RVU

0.64

Facility

$72.81

Non-Facility

$72.81

Results and interpretation of the specific surveillance test performed (NST tracings and accelerations/reactivity, BPP score components and total score, modified BPP results, Doppler indices such as pulsatility index (PI) or resistance index (RI) for umbilical artery, uterine artery, middle cerebral artery, MCA PSV numeric values and comparisons to reference ranges, documentation of absent/reversed end-diastolic flow if present).
Record of maternal self-assessment for fetal movement (kick counts) when used and any associated counseling/education provided.
For remote/home NST or telemonitoring: documentation of device used, dates/times of transmissions, transmitted FHR/NST tracings, clinician review/interpretation, and any follow-up actions (e.g., in-clinic evaluation required or avoided).

Systemic lupus erythematosus (SLE) (M32.10 and O99.89 references)
Supervision of high-risk pregnancy (O09.00 - O09.93)
Fetus-to-fetus placental transfusion syndrome (O43.021 - O43.029)
Proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium (O10.011 - O11.9, O12.10 - O16.9)
Hemorrhage in early pregnancy (O20.0 - O20.9)
Repeat testing (either weekly or twice‑weekly, depending on test and presence of certain high‑risk conditions) while the clinical condition that prompted testing persists.

AETNA-CPB-0088 — Antepartum Fetal Surveillance

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