MyMedi-AI

A6570 — Gradient compression garment, genital region, each

HCPCS Level II A-code · short descriptor: “Grad com garment genital”

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.

A6570 Medicare fee schedule (October 2026)

Base (no modifier) LC

Medicare allowable: $113.28 in all listed states.

StateNon-ruralRural
AK$113.28—
AL$113.28—
AR$113.28—
AZ$113.28—
CA$113.28—
CO$113.28—
CT$113.28—
DC$113.28—
DE$113.28—
FL$113.28—
GA$113.28—
HI$113.28—
IA$113.28—
ID$113.28—
IL$113.28—
IN$113.28—
KS$113.28—
KY$113.28—
LA$113.28—
MA$113.28—
MD$113.28—
ME$113.28—
MI$113.28—
MN$113.28—
MO$113.28—
MS$113.28—
MT$113.28—
NC$113.28—
ND$113.28—
NE$113.28—
NH$113.28—
NJ$113.28—
NM$113.28—
NV$113.28—
NY$113.28—
OH$113.28—
OK$113.28—
OR$113.28—
PA$113.28—
PR$113.28—
RI$113.28—
SC$113.28—
SD$113.28—
TN$113.28—
TX$113.28—
UT$113.28—
VA$113.28—
VI$113.28—
VT$113.28—
WA$113.28—
WI$113.28—
WV$113.28—
WY$113.28—
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 A6570 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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