G9033 Amantadine hcl oral brand

Amantadine hydrochloride, oral brand, per 100 mg (for use in a medicare-approved demonstration project)

Payer policies and prior authorization for G9033

Medicaid fee-for-service

  • WY: $0.00 (professional), effective Jan 1, 2020

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.