Does A4614 require prior authorization?

No, A4614 does not require prior authorization (high confidence). Covered without prior authorization.

What is the Medicare reimbursement rate for A4614?

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

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`A4614`, Peak expiratory flow rate meter, hand held

HCPCS/CPT

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Medicare Pricing

Work RVU

0.00

Facility

N/A

Non-Facility

N/A

Documentation Required

The NHLBI Expert Panel Report guidelines on asthma management recommend that the physician gives the patient written instructions on interpreting the peak flow meter (such as what levels are acceptable, what levels require use of inhalers or other treatments, and what levels indicate that one should seek emergency care).

No explicit claim-submission documentation requirements (e.g., required test results, forms, or prior authorization language) are specified in this policy document beyond the general statement that HCPCS codes are covered 'if selection criteria are met.'

Key Coverage Criteria

HCPCS codes covered if selection criteria are met: S8100 Holding chamber or spacer for use with an inhaler or nebulizer; without mask
HCPCS codes covered if selection criteria are met: S8097 Asthma kit (including but not limited to portable peak expiratory flow meter, instructional video, brochure, and/or spacer)
Aetna considers standard mechanical peak flow meters and spacers for metered-dose inhalers medically necessary durable medical equipment (DME) for members with asthma, bronchitis, emphysema, or other obstructive pulmonary conditions.
HCPCS codes covered if selection criteria are met: A4614 Peak expiratory flow rate meter, hand held
HCPCS codes covered if selection criteria are met: A4627 Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler
HCPCS codes covered if selection criteria are met: S8096 Portable peak flow meter

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`A4614`, Peak expiratory flow rate meter, hand held

Prior Authorization

Medicare Pricing

Documentation Required

Key Coverage Criteria

1 Active Policy

Related Codes

Have a follow-up question?

A4614, Peak expiratory flow rate meter, hand held

Prior Authorization

Medicare Pricing

Documentation Required

Key Coverage Criteria

1 Active Policy

Related Codes

Have a follow-up question?

`A4614`, Peak expiratory flow rate meter, hand held