Question 1

Does M1380 require prior authorization?

Accepted Answer

No, M1380 does not require prior authorization (low confidence). No active coverage policies found for this code.

Question 2

What is the Medicare reimbursement rate for M1380?

Accepted Answer

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

`M1380` — Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under "denominator note" or the long-acting injectable antipsychotic medications listed under "denominator note"

Prior Authorization