Does S9140 require prior authorization?

No, S9140 does not require prior authorization (high confidence). Covered without prior authorization.

What is the Medicare reimbursement rate for S9140?

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

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`S9140`, Diabetic management program, follow-up visit to non-md provider

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

Record that home visits take place during the same period the infusion therapy is ordered/being administered.
Documentation of failed conservative treatments (oral and/or rectal medications and/or non‑pharmacological therapies).

For reauthorization requests, documentation by the ordering provider showing reassessment of the member and rationale/clinical need for continued infusion therapy.

Documented blood pressure readings showing ≥140/90 mm Hg on two occasions at least four hours apart with dates/times and gestational age >20 weeks (or postpartum status and date of delivery).

Key Coverage Criteria

Obstetrical Nurse Assessment
Metoclopramide or Ondansetron Infusion Therapy
Hydration Therapy – one to four liters
Diabetes in Pregnancy Clinical Management Programs
Hypertensive Disorders of Pregnancy Program
Dietary Analysis

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`S9140`, Diabetic management program, follow-up visit to non-md provider

Prior Authorization

Medicare Pricing

Documentation Required

Key Coverage Criteria

1 Active Policy

Related Codes

Have a follow-up question?

S9140, Diabetic management program, follow-up visit to non-md provider

Prior Authorization

Medicare Pricing

Documentation Required

Key Coverage Criteria

1 Active Policy

Related Codes

Have a follow-up question?

`S9140`, Diabetic management program, follow-up visit to non-md provider