Question 1

Does G8540 require prior authorization?

Accepted Answer

No, G8540 does not require prior authorization (low confidence). No active coverage policies found for this code.

Question 2

What is the Medicare reimbursement rate for G8540?

Accepted Answer

Medicare facility rate: N/A. Non-facility rate: N/A. Work RVU: 0.00.

`G8540` — Functional outcome assessment not documented as being performed, documentation the patient is not eligible for a functional outcome assessment using a standardized tool at the time of the encounter

Prior Authorization