MyMedi-AI

A6203 — Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing

HCPCS Level II A-code · short descriptor: “Composite drsg <= 16 sq in”

Code system
HCPCS Level II
Family
A — Medical & surgical supplies, ambulance
Medicare coverage status
Special coverage instructions apply
DMEPOS payment category
Surgical dressings
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.

A6203 Medicare fee schedule (October 2026)

Base (no modifier) Surgical dressings

Medicare allowable ranges from $4.80 to $5.70 depending on state and rural status.

Former-CBA payment limits: ceiling $4.80 · floor $4.08

StateNon-ruralRural
AK$5.22—
AL$4.80—
AR$4.80—
AZ$4.80—
CA$4.80—
CO$4.80—
CT$4.80—
DC$4.80—
DE$4.80—
FL$4.80—
GA$4.80—
HI$5.60—
IA$4.80—
ID$4.80—
IL$4.80—
IN$4.80—
KS$4.80—
KY$4.80—
LA$4.80—
MA$4.80—
MD$4.80—
ME$4.80—
MI$4.80—
MN$4.80—
MO$4.80—
MS$4.80—
MT$4.80—
NC$4.80—
ND$4.80—
NE$4.80—
NH$4.80—
NJ$4.80—
NM$4.80—
NV$4.80—
NY$4.80—
OH$4.80—
OK$4.80—
OR$4.80—
PA$4.80—
PR$5.70—
RI$4.80—
SC$4.80—
SD$4.80—
TN$4.80—
TX$4.80—
UT$4.80—
VA$4.80—
VI$4.80—
VT$4.80—
WA$4.80—
WI$4.80—
WV$4.80—
WY$4.80—
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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