Does A4545 require prior authorization?

No, A4545 does not require prior authorization (high confidence). Covered without prior authorization.

What is the Medicare reimbursement rate for A4545?

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

HCPCS/CPT

No Prior Auth Required

Covered without prior authorization (high confidence)

Work RVU

0.00

Facility

N/A

Non-Facility

N/A

An initial 12-week trial ofpercutaneoustibial nerve stimulation is consideredmedically necessarywhen the following criteria are met (AandB):
Anyof the following are present for at least 3 months, and not due to a neurological condition:Urinary urge incontinence;orUrinary urgency/frequency;orNon-obstructive urinary retention;and
Urinary urge incontinence;or
Urinary urgency/frequency;or
Non-obstructive urinary retention;and
Criteria 1and2 below are met:Clinically significant symptoms are present (for example, frequency, or severity impacts ability to work or participate in activities outside of the home);andSymptoms are refractory to, or individual could not tolerate, conservative treatment (for example, medication, pelvic floor muscle exercises, pelvic floor physical exercises with biofeedback, bladder training, or intermittent catheterizations for non-obstructive urinary retention) for at least a sufficient durat [...]