What is CPT code S0013?

What is CPT code S0013?

HCPCS Code Details – S0013

HCPCS Level II Code Commercial Payers (Temporary Codes) Search
HCPCS Code S0013
Description Long description: Esketamine, nasal spray, 1 mg Short description: Esketamine, nasal spray
HCPCS Modifier1

Does Medicare cover S0013?

For Medicare, the drug is packaged in a G code to report the drug/service combination and S0013 would not be included on the claim. CMS also recommends that the applicant approach the AMA for a CPT code to report the REMS service of administering esketamine when the drug is reported separately.

What is the J code for Spravato?

Esketamine nasal spray (Spravato™) HCPCS code J3490: Billing Guidelines.

Is Spravato covered by Medicare?

Esketamine (Spravato) is almost always covered by insurance, including Medicare, because it is FDA approved and well-studied to be effective and safe.

How do I use CPT 99417?

CPT ® code 99417 may only be reported in conjunction with 99205 or 99215 if the codes were selected based on the time alone and not medical decision making. A service of less than 15 minutes should not be reported.

Can a nurse administer Spravato?

Spravato is FDA-approved, prescribed by a psychiatrist or psychiatric nurse practitioner, and administered in a controlled environment. It is self-administered intranasally in the office under the care and supervision of an on-site registered nurse or trained technician.

How much does Spravato cost?

The cost for Spravato nasal spray (28 mg (56 mg dose)) is around $729 for a supply of 2 spray, depending on the pharmacy you visit. Prices are for cash paying customers only and are not valid with insurance plans.

Can an RN administer Spravato?

Is G0463 a Medicare only code?

G0463 CPT code will not be more appropriate to report for telehealth services due to COVID 19. CPT G0463 is only applicable when service bills to Medicare insurance.

What is the newest depression medication?

On March 5, 2019, the Food and Drug Administration (FDA) approved the first new medication for major depression in decades. The drug is a nasal spray called esketamine, derived from ketamine—an anesthetic that has made waves for its surprising antidepressant effect.

Does Blue Cross cover CPT 99417?

The plan of care must also be present and support the need for prolonged care. If a denial is appealed, this documentation must be submitted with the appeal. Blue Cross and Blue Shield of Minnesota (Blue Cross) provides reimbursement for prolonged physician services codes 99354-99357 and 99415-99417.

How long do you have to stay on SPRAVATO?

If you have any bothersome side effects, your doctor may lower your dosage to 56 mg twice weekly. Spravato is not usually prescribed as a long-term treatment for this condition. Your doctor will determine whether you will keep taking Spravato after 4 weeks.

How does Spravato make you feel?

Risk of sedation and disassociation Boxed warnings alert doctors and patients about the most serious side effects that drugs such as Spravato may cause. Spravato may cause feelings of sedation (extreme sleepiness), anxiousness, or dissociation (feeling disconnected from yourself or your thoughts).