MyMedi-AI

A6523 — Gradient compression garment, arm, padded, for nighttime use, custom, each

HCPCS Level II A-code · short descriptor: “G com garment arm nght custm”

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
LC
Prior authorization
Not on Medicare required-PA list
Face-to-face & WOPD
Not on the required list
Status
Active (April 2026 HCPCS)

Prior authorization

Not on the Medicare required-PA list as of the January 13, 2026 update (74 items). 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 (April 13, 2026 update — 83 items). The standard written order must reach the supplier before claim submission.

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

A6523 Medicare fee schedule (April 2026)

Base (no modifier) LC

Medicare allowable: $729.02 in all listed states.

StateNon-ruralRural
AK$729.02
AL$729.02
AR$729.02
AZ$729.02
CA$729.02
CO$729.02
CT$729.02
DC$729.02
DE$729.02
FL$729.02
GA$729.02
HI$729.02
IA$729.02
ID$729.02
IL$729.02
IN$729.02
KS$729.02
KY$729.02
LA$729.02
MA$729.02
MD$729.02
ME$729.02
MI$729.02
MN$729.02
MO$729.02
MS$729.02
MT$729.02
NC$729.02
ND$729.02
NE$729.02
NH$729.02
NJ$729.02
NM$729.02
NV$729.02
NY$729.02
OH$729.02
OK$729.02
OR$729.02
PA$729.02
PR$729.02
RI$729.02
SC$729.02
SD$729.02
TN$729.02
TX$729.02
UT$729.02
VA$729.02
VI$729.02
VT$729.02
WA$729.02
WI$729.02
WV$729.02
WY$729.02
Amounts are the Medicare DMEPOS fee-schedule allowables effective April 2026. 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

Bill A6523 with confidence

MyMedi-AI scrubs whole claims against NCCI pairs, MUE limits, modifier rules, and PA flags before you submit — built for DME teams, no PHI stored on our servers.

Start free trial   Run a CMS-0057-F readiness check

Prefer DIY compliance? Self-audit documentation kits for DME suppliers →

Building an AI agent? Try the agent API in the playground — free PA-required lookups, A6523 included, and starter credits via POST /bot-marketplace/register.