MyMedi-AI

A6237 — Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing

HCPCS Level II A-code · short descriptor: “Hydrocolld drg <=16 in w/bdr”

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.

A6237 Medicare fee schedule (October 2026)

Base (no modifier) Surgical dressings

Medicare allowable ranges from $11.27 to $13.55 depending on state and rural status.

Former-CBA payment limits: ceiling $11.27 · floor $9.58

StateNon-ruralRural
AK$11.41—
AL$11.27—
AR$11.27—
AZ$11.27—
CA$11.27—
CO$11.27—
CT$11.27—
DC$11.27—
DE$11.27—
FL$11.27—
GA$11.27—
HI$12.18—
IA$11.27—
ID$11.27—
IL$11.27—
IN$11.27—
KS$11.27—
KY$11.27—
LA$11.27—
MA$11.27—
MD$11.27—
ME$11.27—
MI$11.27—
MN$11.27—
MO$11.27—
MS$11.27—
MT$11.27—
NC$11.27—
ND$11.27—
NE$11.27—
NH$11.27—
NJ$11.27—
NM$11.27—
NV$11.27—
NY$11.27—
OH$11.27—
OK$11.27—
OR$11.27—
PA$11.27—
PR$13.55—
RI$11.27—
SC$11.27—
SD$11.27—
TN$11.27—
TX$11.27—
UT$11.27—
VA$11.27—
VI$11.27—
VT$11.27—
WA$11.27—
WI$11.27—
WV$11.27—
WY$11.27—
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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