Question 1

Does M1238 require prior authorization?

Accepted Answer

No, M1238 does not require prior authorization (low confidence). No active coverage policies found for this code.

Question 2

What is the Medicare reimbursement rate for M1238?

Accepted Answer

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

`M1238` — Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)

Prior Authorization