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A6572 — Gradient compression garment, toe caps, each

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

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
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.

A6572 Medicare fee schedule (April 2026)

Base (no modifier) LC

Medicare allowable: $105.11 in all listed states.

StateNon-ruralRural
AK$105.11
AL$105.11
AR$105.11
AZ$105.11
CA$105.11
CO$105.11
CT$105.11
DC$105.11
DE$105.11
FL$105.11
GA$105.11
HI$105.11
IA$105.11
ID$105.11
IL$105.11
IN$105.11
KS$105.11
KY$105.11
LA$105.11
MA$105.11
MD$105.11
ME$105.11
MI$105.11
MN$105.11
MO$105.11
MS$105.11
MT$105.11
NC$105.11
ND$105.11
NE$105.11
NH$105.11
NJ$105.11
NM$105.11
NV$105.11
NY$105.11
OH$105.11
OK$105.11
OR$105.11
PA$105.11
PR$105.11
RI$105.11
SC$105.11
SD$105.11
TN$105.11
TX$105.11
UT$105.11
VA$105.11
VI$105.11
VT$105.11
WA$105.11
WI$105.11
WV$105.11
WY$105.11
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

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