Does J2787 require prior authorization?

No, J2787 does not require prior authorization (high confidence). Covered without prior authorization.

What is the Medicare reimbursement rate for J2787?

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

Increase of 1.00 D or more in manifest cylinder;or
Increase of 0.50 D or more in manifest refraction spherical equivalent (MRSE);and
Age 14 years or older;and
Increase of 1.00 diopters (D) or more in the steepest keratometry measurement;or
Corneal collagen cross-linking (CXL) is consideredmedically necessaryas a treatment for progressive keratoconus when all of the following conditions are met:
Diagnosis of keratoconus based on keratometry and corneal mapping;and