MyMedi-AI

A6568 — Gradient compression garment, torso and shoulder, each

HCPCS Level II A-code · short descriptor: “G com garment torso/shldr”

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 2026-10-25; 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.

A6568 Medicare fee schedule (October 2026)

Base (no modifier) LC

Medicare allowable: $166.26 in all listed states.

StateNon-ruralRural
AK$166.26—
AL$166.26—
AR$166.26—
AZ$166.26—
CA$166.26—
CO$166.26—
CT$166.26—
DC$166.26—
DE$166.26—
FL$166.26—
GA$166.26—
HI$166.26—
IA$166.26—
ID$166.26—
IL$166.26—
IN$166.26—
KS$166.26—
KY$166.26—
LA$166.26—
MA$166.26—
MD$166.26—
ME$166.26—
MI$166.26—
MN$166.26—
MO$166.26—
MS$166.26—
MT$166.26—
NC$166.26—
ND$166.26—
NE$166.26—
NH$166.26—
NJ$166.26—
NM$166.26—
NV$166.26—
NY$166.26—
OH$166.26—
OK$166.26—
OR$166.26—
PA$166.26—
PR$166.26—
RI$166.26—
SC$166.26—
SD$166.26—
TN$166.26—
TX$166.26—
UT$166.26—
VA$166.26—
VI$166.26—
VT$166.26—
WA$166.26—
WI$166.26—
WV$166.26—
WY$166.26—
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 A6568 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

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