Medicare Benefits Schedule - Note TN.8.91

For the purposes of the above items, one aesthetic area is any of the following of the whole face (considered to be divided into six segments):- forehead; right cheek; left cheek; nose; upper lip; and chin. 

Items 45021 and 45024 cover abrasive therapy only. For the purposes of these items, abrasive therapy requires the removal of the epidermis and into the deeper papillary dermis. Services performed using a laser are not eligible for benefits under these items. 

Items 45025 and 45026 do not cover the use of fractional (Fraxel^®) laser therapy.

Related Items: 45021 45024 45025 45026

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Multiple Operation Rule

ABRASIVE THERAPY for severely disfiguring scarring resulting from trauma, burns or acne - limited to 1 aesthetic area

(Anaes.)

Fee: $187.50 Benefit: 75% = $140.65 85% = $159.40

(See para TN.8.91 of explanatory notes to this Category)

Multiple Operation Rule

ABRASIVE THERAPY for severely disfiguring scarring resulting from trauma, burns or acne - more than 1 aesthetic area

(Anaes.)

Fee: $421.35 Benefit: 75% = $316.05 85% = $358.15

(See para TN.8.91 of explanatory notes to this Category)

Multiple Operation Rule

CARBON DIOXIDE LASER OR ERBIUM LASER (not including fractional laser therapy) resurfacing of the face or neck for severely disfiguring scarring resulting from trauma, burns or acne - limited to 1 aesthetic area

(Anaes.)

Fee: $187.50 Benefit: 75% = $140.65 85% = $159.40

(See para TN.8.91 of explanatory notes to this Category)

Multiple Operation Rule

CARBON DIOXIDE LASER OR ERBIUM LASER (not including fractional laser therapy) resurfacing of the face or neck for severely disfiguring scarring resulting from trauma, burns or acne - more than 1 aesthetic area

(Anaes.)

Fee: $421.35 Benefit: 75% = $316.05 85% = $358.15

(See para TN.8.91 of explanatory notes to this Category)