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10/01/2024 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products (Updated October 8, 2024)


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
A9610

NOT ELIGIBLE FOR REIMBURSEMENT
Q0519Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription injectable drug, per 30-days*
Q0520Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription injectable drug, per 60-days*

NOT-COVERED SERVICES
J8522
J8541

*Effective 9/15/2024

10/08/2024