Does T1505 require prior authorization?

No, T1505 does not require prior authorization (high confidence). Covered without prior authorization.

What is the Medicare reimbursement rate for T1505?

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

Mobile-based health management applications are consideredmedically necessarywhenallof the following criteria in I and II have been met:
Criteria to evaluate the mobile software application (MSA):The MSA has been approved or cleared by the Food and Drug Administration (FDA);andThere is credible scientific evidence which permits reasonable conclusions regarding the impact of the MSA on health outcomes;andThe MSA has been proven materially to improve the net health outcome or be as beneficial as any established alternative;AND
The MSA has been approved or cleared by the Food and Drug Administration (FDA);and
There is credible scientific evidence which permits reasonable conclusions regarding the impact of the MSA on health outcomes;and
The MSA has been proven materially to improve the net health outcome or be as beneficial as any established alternative;AND
Criteria to evaluate the appropriateness of the MSA for the individual:The MSA has been prescribed by a healthcare practitioner;andThere is documentation supporting that the MSA was ordered for a covered purpose such as preventing, evaluating, diagnosing or treating an illness, injury, disease or its symptoms, and in accordance with generally accepted standards of medical practice;*andThe requested MSA is not primarily for the convenience of the individual, prescribing clinician, caregiver, or o [...]