Question 1

Does M1255 require prior authorization?

Accepted Answer

No, M1255 does not require prior authorization (low confidence). No active coverage policies found for this code.

Question 2

What is the Medicare reimbursement rate for M1255?

Accepted Answer

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

`M1255` — Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)

Prior Authorization