Does 60254 require prior authorization?

No, 60254 does not require prior authorization (high confidence). Code is covered without prior authorization.

What is the Medicare reimbursement rate for 60254?

Medicare facility rate: $1481.66. Non-facility rate: $1481.66. Work RVU: 27.71.

HCPCS/CPT

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Work RVU

27.71

Facility

$1481.66

Non-Facility

$1481.66

Record of FNA specimen adequacy (eg, presence/absence of sufficient number of follicular cells).
Documentation if specimen was obscured by blood or contained cyst fluid only.
No documentation requirements are provided in the supplied excerpt.
The Table of Contents lists an Appendix and 'Coverage Determination' where documentation requirements would normally appear, but those details are not included here.

First-degree relative with thyroid cancer or multiple endocrine neoplasia type 2 (MEN2) syndrome
Thyroidectomy & Lobectomy (title indicates coverage policy applies to these thyroid surgeries).
Medicare Advantage Medical Coverage Policy for thyroid surgeries — no additional specific covered diagnoses or clinical scenarios are present in the provided excerpt.
Evaluation and treatment of goiters.
Goiter volume of 80 grams or greater.
The following criteria applies to all jurisdictions.

HUMANA-THYROID-SURGERIES-THYROIDECTOMY-LOBECTOMY-MA — Thyroid Surgeries (Thyroidectomy & Lobectomy) - Medicare Advantage

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