Prior Auth Required

99473 - includes raising awareness of the new Current Procedural Terminology [CPT] codes ( and

This procedure appears on the selected insurer prior authorization source.

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Procedure / Serviceincludes raising awareness of the new Current Procedural Terminology [CPT] codes ( and
Procedure / Service Description

across payers with notes explaining which devices and/or services were covered and for whom. - With the extensive gaps in coverage and education identified, Million Hearts®, in collaboration with NACDD and other public and private partners, are recommitting efforts to optimize use of SMBP. This includes raising awareness of the new Current Procedural Terminology [CPT] codes (99473 and 99474)3 that can be used to bill for the provision of SMBP services.

Likely documents
  • Confirm benefit details
  • Submit clinical notes if requested by the plan
Next actions
  • Confirm the current plan policy before submission.
  • Use the insurer authorization workflow for this listed code.