V5363, Language screening
HCPCS/CPT
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Medicare Pricing
Work RVU
0.00
Facility
N/A
Non-Facility
N/A
Documentation Required
- Initial PT evaluation must document ALL required elements as listed.
- PT plan of care must include ALL required components.
- Requests for more than an evaluation visit may require peer-to-peer review to determine medical necessity.
Key Coverage Criteria
- Medically necessary initiation of physical therapy requires criteria for both A (initial evaluation) and B (plan of care) to be met.
1 Active Policy
CARELON-physical-therapy-occupational-therapy-and-speech-therapy-2024-04-14, Physical Therapy Occupational Therapy and Speech Therapy
Related Codes
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