Varithena reimbursement and coverage

Effective July 1, 2024, UnitedHealthcare® (UHC), Oxford, Health Plan of Nevada, UMR, and Sierra Nevada Health Plan cover Varithena.

Insurance coverage for Varithena

Varithena is included in a majority of regional and national payor's polices and local coverage decisions.1

Varithena covers of guides

CPT codes help simplify your practice.

The list below contains possible CPT codes that may be used to report treatment with Varithena. Per CPT instructions, the code selected should accurately describe the service performed.

36465 Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; single incompetent extremity truncal vein (e.g., great saphenous vein, accessory saphenous vein).
36466Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; multiple incompetent truncal veins (e.g., great saphenous vein, accessory saphenous vein), same leg.
36470Injection of sclerosant; single incompetent vein (other than telangiectasia).
36471Injection of sclerosant; multiple incompetent veins (other than telangiectasia) same leg.

2024 Medicare physician fee schedule final rule

Varithena may be billed with one of the following CPT codes listed below, for the physician office setting.

CPT codeDescriptionTotal RVUsPayment
36465Varithena: 1 vein38.22$1,272
36466Varithena: >1 vein40.36$1,343
36470Sclerotherapy: 1 vein3.46$115
36471Sclerotherapy: >1 vein5.99$199

1. 2024 CMS Physician Fee Schedule. CMS-1784-F. Effective through December 31, 2024. Conversion factor $33.2875.

Reimbursement request


Looking for more Varithena?

Varithena can be ordered directly through Boston Scientific.


References

1. Data on file. Provensis Ltd, 2013.

Disclaimer

Health economic and reimbursement information provided by Boston Scientific Corporation is gathered from third-party sources and is subject to change without notice as a result of complex and frequently changing laws, regulations, rules and policies. This information is presented for illustrative purposes only and does not constitute reimbursement or legal advice. Boston Scientific encourages physicians to submit accurate and appropriate claims for services. It is always the physician's responsibility to determine medical necessity, the proper site for delivery of any services and to submit appropriate codes, charges, and modifiers for services that are rendered. Boston Scientific recommends that you consult with your payers, reimbursement specialists and/or legal counsel regarding coding, coverage and reimbursement matters. It is always the physician's responsibility to understand and comply with national coverage determinations (NCD), local coverage determinations (LCD) and any other coverage requirements established by relevant payers which can be updated frequently.

CPT® Copyright 2023 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association. Applicable FARS/DFARS Restrictions Apply to Government Use. Fee schedules, relative value units, conversion factors, and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.