MyMedi-AI

A6538 — Gradient compression stocking, full length/chap style, 40 mmhg or greater, each

HCPCS Level II A-code · short descriptor: “Gc stocking full lngth 40+”

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
MUE unit limit
6
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 2026-10-16; 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 2026-10-16; 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.

A6538 Medicare fee schedule (October 2026)

Base (no modifier) LC

Medicare allowable: $102.65 in all listed states.

StateNon-ruralRural
AK$102.65—
AL$102.65—
AR$102.65—
AZ$102.65—
CA$102.65—
CO$102.65—
CT$102.65—
DC$102.65—
DE$102.65—
FL$102.65—
GA$102.65—
HI$102.65—
IA$102.65—
ID$102.65—
IL$102.65—
IN$102.65—
KS$102.65—
KY$102.65—
LA$102.65—
MA$102.65—
MD$102.65—
ME$102.65—
MI$102.65—
MN$102.65—
MO$102.65—
MS$102.65—
MT$102.65—
NC$102.65—
ND$102.65—
NE$102.65—
NH$102.65—
NJ$102.65—
NM$102.65—
NV$102.65—
NY$102.65—
OH$102.65—
OK$102.65—
OR$102.65—
PA$102.65—
PR$102.65—
RI$102.65—
SC$102.65—
SD$102.65—
TN$102.65—
TX$102.65—
UT$102.65—
VA$102.65—
VI$102.65—
VT$102.65—
WA$102.65—
WI$102.65—
WV$102.65—
WY$102.65—
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.

Unit limit (MUE)

Medicare's Medically Unlikely Edit caps A6538 at 6 units per date of service (absolute). Units above the MUE deny — typically as CO-151. Rationale: CMS Policy.

Common denial codes to watch

Related A-codes

Bill A6538 with confidence

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