MyMedi-AI

A7026 — High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each

HCPCS Level II A-code · short descriptor: “Replace chst cmprss sys hose”

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
MUE unit limit
1
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 2026-10-26; 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 2026-10-26; 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.

A7026 Medicare fee schedule (October 2026)

NU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $40.96 to $49.15 depending on state and rural status.

Former-CBA payment limits: ceiling $40.96 · floor $34.82

StateNon-ruralRural
AK$40.96—
AL$40.96—
AR$40.96—
AZ$40.96—
CA$40.96—
CO$40.96—
CT$40.96—
DC$40.96—
DE$40.96—
FL$40.96—
GA$40.96—
HI$40.96—
IA$40.96—
ID$40.96—
IL$40.96—
IN$40.96—
KS$40.96—
KY$40.96—
LA$40.96—
MA$40.96—
MD$40.96—
ME$40.96—
MI$40.96—
MN$40.96—
MO$40.96—
MS$40.96—
MT$40.96—
NC$40.96—
ND$40.96—
NE$40.96—
NH$40.96—
NJ$40.96—
NM$40.96—
NV$40.96—
NY$40.96—
OH$40.96—
OK$40.96—
OR$40.96—
PA$40.96—
PR$49.15—
RI$40.96—
SC$40.96—
SD$40.96—
TN$40.96—
TX$40.96—
UT$40.96—
VA$40.96—
VI$40.96—
VT$40.96—
WA$40.96—
WI$40.96—
WV$40.96—
WY$40.96—
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 A7026 at 1 unit per date of service (clinical). Units above the MUE deny — typically as CO-151. Rationale: Clinical: Data.

Common denial codes to watch

Related A-codes

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