Does 61650 require prior authorization?

No, 61650 does not require prior authorization (high confidence). Code is covered without prior authorization.

What is the Medicare reimbursement rate for 61650?

Medicare facility rate: $523.39. Non-facility rate: $523.39. Work RVU: 9.75.

HCPCS/CPT

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Work RVU

9.75

Facility

$523.39

Non-Facility

$523.39

The patient's medical record must include the ordering provider's assessment related to the visit complaint, relevant medical history, results of pertinent tests/procedures, and a signed and dated office visit record or operative report.
Medical records must specify medications infused (names and dosages), infusion start and end times, route of administration, vessel infused, and medical indications for the procedure; documentation must be available to Medicare upon request.
For services requiring a referring/ordering physician, the name and NPI of the referring/ordering physician must be reported on the claim.
For Part A inpatient hospital claims, the hospital must report the principal diagnosis in UB-04 FL 67 and the admitting diagnosis in FL 69; up to eight additional ICD‑10‑CM codes go in FLs 67A-67Q.

Claims for patients treated for Raynaud's syndrome may be billed in office (11), inpatient hospital (21), outpatient hospital (22), ambulatory surgical center (24), or independent clinic (49).
Transcatheter infusion therapy (report with CPT 61650, 61651, or 37202 as appropriate) is covered when medically necessary to treat vascular conditions requiring intra-arterial medication infusion.
Claims for patients treated for cerebrovasospasm may be submitted (treatment-specific billing) and must be billed with place of service inpatient hospital (21).
Claims for patients treated for bleeding involving the head or neck may be submitted and must be billed with place of service inpatient hospital (21).
Claims for patients treated for gastrointestinal hemorrhage may be submitted and must be billed with place of service inpatient hospital (21).
Claims for patients treated for non-occlusive mesenteric ischemia may be submitted and must be billed with place of service inpatient hospital (21).

CGS-L34084 — Transcatheter Infusion Therapy

J18 MAC Part B

A56811 — Billing and Coding: Transcatheter Infusion Therapy

L34084 — Transcatheter Infusion Therapy

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