Does A9515 require prior authorization?

No, A9515 does not require prior authorization (high confidence). Covered without prior authorization.

What is the Medicare reimbursement rate for A9515?

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

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`A9515`, Choline c-11, diagnostic, per study dose up to 20 millicuries

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

Documentation may be required to support requests for imaging; the documentation must reflect the clinical situation and document the ordering clinician’s intent.

Key Coverage Criteria

Advanced imaging is medically necessary for diagnostic workup, management, and surveillance of documented primary CNS cancer.
Annual MRI breast screening indicated for individuals who received chest radiation between ages 10 and 30.
Annual MRI breast screening indicated for individuals with BRCA1 or BRCA2 mutations.

Annual MRI breast imaging indicated for individuals with extremely dense breast tissue aged 50 or older.

Annual MRI breast screening indicated for individuals with lifetime breast cancer risk ≥20% as defined by specified models.

Screening CT colonography indicated for average-risk individuals as an alternative to conventional colonoscopy at 5-year intervals, starting at age 45.

2 Active Policies

CARELON-oncologic-imaging-2025-11-15, Oncologic Imaging

CARELON-oncologic-imaging-2026-04-04, Oncologic Imaging

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A9515, Choline c-11, diagnostic, per study dose up to 20 millicuries