Does G0294 require prior authorization?

No, G0294 does not require prior authorization (high confidence). Covered without prior authorization.

What is the Medicare reimbursement rate for G0294?

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

Medical records documentation may be required to assess whether the member meets the clinical criteria for coverage, but it does not guarantee coverage; reference member plan documents and guidelines.
Medical records documentation may be required to assess whether the member meets the clinical criteria for coverage (may be required by benefit plan or laws) but does not guarantee coverage.

Cover Routine Patient Costs for a Qualifying Individual participating in an Approved Clinical Trial as required by PPACA for plan years starting on/after 2014; benefits include reasonable and necessary items/services to prevent, diagnose, and treat complications arising from participation.
Routine patient costs coverage for services and/or items provided within a clinical trial.
Routine patient costs coverage for services and/or items provided within a clinical trial.
Routine patient costs coverage for services and/or items provided within a clinical trial.
PPACA requires non-grandfathered plans to cover Routine Patient Costs for a Qualifying Individual in an Approved Clinical Trial; benefits include reasonable and necessary items and services to prevent, diagnose, and treat complications arising from participation in the trial.
Cover routine patient costs for qualifying individuals participating in an approved clinical trial as defined under PPACA (for plan years starting on or after 01/01/2014).

UHC-POL-clinical-trials, Clinical Trials

BCBSIL-ADM1001.027, Clinical Trial Treatment or Therapy

BCBSMT-ADM1001.027, Clinical Trial Treatment or Therapy

BCBSNM-ADM1001.027, Clinical Trial Treatment or Therapy

BCBSOK-ADM1001.027, Clinical Trial Treatment or Therapy

UMR-POL-UMR-clinical-trials, Clinical Trials

SUREST-POL-SUREST-clinical-trials, Clinical Trials