`S0311` Comp mgmt care coord adv ill

Comprehensive management and care coordination for advanced illness, per calendar month

Medicare coverage: Not payable by Medicare
Status: active (October 2026 file)

Medicare pricing for S0311

Physician Fee Schedule (CY 2026, RVU26D)

Status I: not valid for Medicare (Medicare uses another code).

Payer policies and prior authorization for S0311

1 of 1 payer prior-auth lists that name S0311 require prior authorization or set conditions: UnitedHealthcare Community Plan.

Payer	Plan	State	Prior auth	Conditions	Since	Source
UnitedHealthcare Community Plan	New Jersey FamilyCare	NJ	prior auth required		Oct 1, 2026	Prior authorization requirements for UnitedHealthcare Community Plan of New Jersey Effective October 1, 2026 General Information This list contains prior authorization requirements for participating U

Recent prior-auth changes

May 1, 2026: PA added, UnitedHealthcare Community Plan
Apr 1, 2026: PA added, uhc:pa:summary-of-changes

Medicaid fee-for-service

Prior authorization required or conditional in IN.

KS: $0.00 (default), effective Apr 1, 2020
ND: $0.00 (physician), effective Aug 1, 2026
WA: $1495.00 (specialized_mental_health), effective Jul 1, 2026
WY: $0.00 (professional), effective Jul 1, 2016

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.

S0311 Comp mgmt care coord adv ill