MyMedi-AI

A4565 — Slings

HCPCS Level II A-code

Code system
HCPCS Level II
Family
A — Medical & surgical supplies, ambulance
Medicare coverage status
Carrier judgment — coverage decided by the DME MAC
DMEPOS payment category
SC
Prior authorization
Not on Medicare required-PA list
Face-to-face & WOPD
Not on the required list
Status
Active (HCPCS Level II October 2026)

Prior authorization

Not on the Medicare required-PA list (CMS Required Prior Authorization List — 74 items in force on 2026-10-25; 8 more from 2026-10-28; sources: CMS list updated 2026-01-13, CMS-6109-N (91 FR 47972)). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.

Order readiness — what the written order must contain

Every Medicare DMEPOS claim needs a Standard Written Order with all six elements (42 CFR 410.38(d)):

  • Beneficiary name or Medicare Beneficiary Identifier (MBI) (42 CFR 410.38(d)(1)(i)(A))
  • General description of the item (42 CFR 410.38(d)(1)(i)(B))
  • Quantity to be dispensed, if applicable (42 CFR 410.38(d)(1)(i)(C))
  • Order date (42 CFR 410.38(d)(1)(i)(D))
  • Treating practitioner name or NPI (42 CFR 410.38(d)(1)(i)(E))
  • Treating practitioner signature (42 CFR 410.38(d)(1)(i)(F))

Not on the F2F/WOPD list (CMS Required F2F & WOPD List — 83 items in force on 2026-10-25; 22 more from 2026-10-28; sources: CMS list effective 2026-04-13 (91 FR 1250), CMS-6109-N (91 FR 47972)). The standard written order must reach the supplier before claim submission.

Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.

A4565 Medicare fee schedule (October 2026)

Base (no modifier) SC

Medicare allowable: $10.98 in all listed states.

Former-CBA payment limits: ceiling $10.98 · floor $9.33

StateNon-ruralRural
AK$10.98—
AL$10.98—
AR$10.98—
AZ$10.98—
CA$10.98—
CO$10.98—
CT$10.98—
DC$10.98—
DE$10.98—
FL$10.98—
GA$10.98—
HI$10.98—
IA$10.98—
ID$10.98—
IL$10.98—
IN$10.98—
KS$10.98—
KY$10.98—
LA$10.98—
MA$10.98—
MD$10.98—
ME$10.98—
MI$10.98—
MN$10.98—
MO$10.98—
MS$10.98—
MT$10.98—
NC$10.98—
ND$10.98—
NE$10.98—
NH$10.98—
NJ$10.98—
NM$10.98—
NV$10.98—
NY$10.98—
OH$10.98—
OK$10.98—
OR$10.98—
PA$10.98—
PR$10.98—
RI$10.98—
SC$10.98—
SD$10.98—
TN$10.98—
TX$10.98—
UT$10.98—
VA$10.98—
VI$10.98—
VT$10.98—
WA$10.98—
WI$10.98—
WV$10.98—
WY$10.98—
Amounts are the Medicare DMEPOS fee-schedule allowables effective October 2026 (CMS DMEPOS Fee Schedule October 2026 (DME26-D)). Medicare typically pays 80% of the allowable after the Part B deductible; the patient owes 20%. A 2% sequestration reduction applies to the Medicare share. Former competitive-bidding-area adjustments and non-continental rates can differ — verify with your DME MAC.

Common denial codes to watch

Related A-codes

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