Reimbursement for PROKER®

Topic: Amniotic Membrane

Sponsor: BioTissue

Updated: 08/08/2022

BioTissue

This FAQ addresses the following:

  1. What is PROKERA®?
  2. What CPT code describes administration of Prokera?
  3. Does Medicare cover placement of a Prokera biologic corneal bandage?
  4. What are the indications for Prokera?
  5. What is the Medicare allowed amount for physicians performing 65778?
  6. What does Medicare allow as a facility fee for 65778?
  7. Does Medicare pay for the supply of Prokera separately?
  8. What is the postoperative surgical period for 65778?
  9. How am I reimbursed for using Prokera during the postoperative period of another procedure?
  10. How is Prokera reimbursed when used after corneal surgery?