Does A4544 require prior authorization?

No, A4544 does not require prior authorization (medium confidence). Covered without prior authorization by at least one policy, though another does not cover it.

What is the Medicare reimbursement rate for A4544?

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

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`A4544`, Electrode for external lower extremity nerve stimulator for restless legs

HCPCS/CPT

Prior Authorization

No Prior Auth Required

Covered without prior authorization by at least one policy, though another does not cover it (medium confidence)

Medicare Pricing

Work RVU

0.00

Facility

N/A

Non-Facility

N/A

Documentation Required

Claims may require medical records documentation to assess whether the member meets the clinical criteria for coverage; however, documentation does not guarantee coverage.
Medical Records Documentation Used for Reviews

Key Coverage Criteria

Transcutaneous electrical nerve stimulator (TENS) is proven and medically necessary in certain circumstances.
Transcutaneous electrical nerve stimulator (TENS) is proven and medically necessary in certain circumstances.
Tonic motor activation as a treatment for restless legs syndrome refractory to medication is considered experimental, investigational and/or unproven.
Tonic motor activation as a treatment for restless legs syndrome refractory to medication is considered experimental, investigational and/or unproven.
Tonic motor activation as a treatment for restless legs syndrome refractory to medication is considered experimental, investigational and/or unproven.

9 Active Policies

ANTHEM-DME.00011, Electrical Stimulation as a Treatment for Pain and Other Conditions: Surface and Percutaneous Devices

UHC-POL-electrical-stimulation-treatment-pain-muscle-rehabilitation, Electrical Stimulation for the Treatment of Pain and Muscle Rehabilitation

UMR-POL-UMR-electrical-stimulation-treatment-pain-muscle-rehabilitation, Electrical Stimulation for the Treatment of Pain and Muscle Rehabilitation

SUREST-POL-SUREST-electrical-stimulation-treatment-pain-muscle-rehabilitation, Electrical Stimulation for the Treatment of Pain and Muscle Rehabilitation

BCBSIL-DME101.053, Tonic Motor Activation for Restless Legs Syndrome

BCBSMT-DME101.053, Tonic Motor Activation for Restless Legs Syndrome

BCBSNM-DME101.053, Tonic Motor Activation for Restless Legs Syndrome

BCBSOK-DME101.053, Tonic Motor Activation for Restless Legs Syndrome

CARELON-sleep-disorder-management-2025-11-15-updated-2026-07-01, Sleep Disorder Management

`A4544`, Electrode for external lower extremity nerve stimulator for restless legs

Prior Authorization

Medicare Pricing

Documentation Required

Key Coverage Criteria

9 Active Policies

Related Codes

Have a follow-up question?

A4544, Electrode for external lower extremity nerve stimulator for restless legs

Prior Authorization

Medicare Pricing

Documentation Required

Key Coverage Criteria

9 Active Policies

Related Codes

Have a follow-up question?

`A4544`, Electrode for external lower extremity nerve stimulator for restless legs