Premera Blue Cross of Washington prior authorization G2082

Premera Blue Cross of Washington prior authorization for G2082: Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of up to 56 mg of esketamine nasal self administration, includes 2 hours post administration observation

Code
G2082
Description
Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of up to 56 mg of esketamine nasal self administration, includes 2 hours post administration observation
Source
Clinical Review by Code List PBCWA, Pg 689 Original policy

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