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10/01/2024 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products (Updated October 8, 2024)
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Inclusion of a code in this document does not imply reimbursement. Medical Necessity, eligibility, benefits, limitations, exclusions, precertification/referral requirements, provider contracts, and Company policies apply.
ELIGIBLE SERVICES
0478U |
0481U |
0483U |
0484U |
0488U |
0494U |
0499U |
0500U |
A2027 |
A2028 |
A7021 |
C9169 |
C9170 |
C9171 |
C9172 |
E0469 |
E2513 |
J0138 |
J1171 |
J1749 |
J2002 |
J2003 |
J2004 |
J2252 |
J2253 |
J2601 |
J8522 |
J8541 |
J9329 |
L1006 |
L1653 |
L1821 |
Q4336 |
Q4337 |
Q4338 |
Q4339 |
Q4340 |
Q4341 |
Q4342 |
Q4344 |
Q4345 |
Q5135 |
Q5136
|
EXPERIMENTAL/INVESTIGATIONAL SERVICES
0476U |
0477U |
0479U |
0480U |
0482U |
0485U |
0486U |
0487U |
0489U |
0490U |
0491U |
0492U |
0495U |
0496U |
0497U |
0498U |
0501U |
0502U |
0503U |
0504U |
0505U |
0506U |
0507U |
0508U |
0509U |
0510U |
0511U |
0512U |
0513U |
0514U |
0515U |
0516U |
0517U |
0518U |
0519U |
0520U |
90624
|
A2029 |
A4543 |
A4544 |
A4545 |
C8000 |
E0683 |
E0715 |
E0716 |
E0721 |
E0737 |
E0743 |
E0767 |
E3200 |
L8720 |
L8721 |
P9027 |
Q4334 |
Q4335 |
Q4343
|
SERVICES NOT ELIGIBLE FOR SEPARATE REIMBURSEMENT
NOT ELIGIBLE FOR REIMBURSEMENT
Q0519 | Pharmacy
supplying fee for hiv pre-exposure prophylaxis fda approved prescription
injectable drug, per 30-days*
|
Q0520 | Pharmacy
supplying fee for hiv pre-exposure prophylaxis fda approved prescription
injectable drug, per 60-days*
|
NOT-COVERED SERVICES
*Effective 9/15/2024