S5185 Med reminder serv per monthMedication reminder service, non-face-to-face; per month
Status I: not valid for Medicare (Medicare uses another code).
3 of 3 payer prior-auth lists that name S5185 require prior authorization or set conditions: Humana, Molina Complete Care (Virginia).
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Humana | Humana LTSS (Healthy Horizons) | VA | prior auth required | Jul 1, 2025 | Humana Healthy Horizons® in Virginia Long-Term Services and Supports (LTSS) Prior Authorization and Notification List | |
| Molina Complete Care (Virginia) | Virginia state exceptions to the national Medicaid grid (exceptions only) | VA | prior auth required | State exception | Apr 1, 2025 | Virginia Medicaid PA Code Matrix and Virginia code/benefit exceptions, effective Q2 2025 |
| Molina Complete Care (Virginia) | Medicaid | VA | prior auth required | State exception | Apr 1, 2025 | Virginia Medicaid PA Code Matrix and Virginia code/benefit exceptions, effective Q2 2025 |
S5185 appears in 2 coverage policies from Blue Cross & Blue Shield of Mississippi, Premera Blue Cross.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Blue Cross & Blue Shield of Mississippi | Telehealth Remote Patient Monitoring Services (L.2.04.439) | listed, no stance | payer document | |
| Premera Blue Cross | Non-covered Services and Procedures Page | 19 of 30 | ∞ | not covered | Jun 1, 2026 | payer document |
Prior authorization required or conditional in IN, VA, WY.
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.