Negotiated reimbursement rates for D0481 across 2 states, sourced from CMS Transparency in Coverage data. 5 rate records.
D0481 refers to Electron Microscopy, a diagnostic procedure used to examine tissue samples at a very high magnification. This technique is particularly useful for identifying cellular structures and abnormalities that are not visible through standard light microscopy. Clinical indications for this procedure include the evaluation of complex lesions, tumors, or other pathological conditions requiring detailed analysis. When billing for this service, it is essential to document the clinical rationale for the procedure, including any specific findings that necessitated the use of electron microscopy. Reimbursement for D0481 can vary significantly by payor and state, with average reimbursements around $120. Some insurance plans may require prior authorization or additional documentation to justify the need for this advanced diagnostic tool, while others may have specific limitations on coverage based on the patient's diagnosis or treatment plan.
Reimbursement rates for D0481 vary significantly by state, payor, and provider network. The national average negotiated rate is $120. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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