MyMedi-AI

A7005 — Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable

HCPCS Level II A-code · short descriptor: “Nondisposable nebulizer set”

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
Inexpensive or routinely purchased
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.

A7005 Medicare fee schedule (April 2026)

NU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $11.77 to $30.13 depending on state and rural status.

StateNon-ruralRural
AK$27.86
AL$15.02$26.84
AR$15.02$26.84
AZ$13.99$30.13
CA$11.77$30.13
CO$16.32$26.84
CT$14.28$29.04
DC$13.42$30.13
DE$13.42$27.97
FL$15.02$26.84
GA$15.02$26.84
HI$29.20
IA$14.83$30.13
ID$16.32$30.13
IL$16.10$30.13
IN$16.10$30.13
KS$14.83$30.13
KY$15.02$26.84
LA$15.02$26.84
MA$14.28$28.97
MD$13.42$30.13
ME$14.28$29.35
MI$16.10$30.13
MN$14.83$30.13
MO$14.83$30.13
MS$15.02$26.84
MT$16.32$30.13
NC$15.02$26.84
ND$14.83$30.13
NE$14.83$30.13
NH$14.28$27.97
NJ$13.42$27.97
NM$13.99$26.84
NV$11.77$30.13
NY$13.42$27.97
OH$16.10$30.13
OK$13.99$26.84
OR$11.77$30.13
PA$13.42$27.97
PR$22.68
RI$14.28$27.97
SC$15.02$26.84
SD$14.83$30.13
TN$15.02$26.84
TX$13.99$26.84
UT$16.32$30.13
VA$15.02$30.13
VI$27.97
VT$14.28$28.76
WA$11.77$30.13
WI$16.10$30.13
WV$15.02$30.13
WY$16.32$30.13
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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