A7037 — Tubing used with positive airway pressure device

HCPCS Level II A-code · short descriptor: “Pos airway pressure tubing”

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.

A7037 Medicare fee schedule (April 2026)

NU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $14.19 to $36.48 depending on state and rural status.

State	Non-rural	Rural
AK	$30.43	—
AL	$14.77	$33.51
AR	$14.77	$33.27
AZ	$14.74	$33.51
CA	$15.64	$33.51
CO	$15.58	$33.40
CT	$15.46	$33.51
DC	$14.93	$33.43
DE	$14.93	$32.40
FL	$14.77	$31.86
GA	$14.77	$32.82
HI	$31.97	—
IA	$14.19	$33.51
ID	$15.58	$33.51
IL	$14.90	$33.43
IN	$14.90	$33.51
KS	$14.19	$33.51
KY	$14.77	$33.05
LA	$14.77	$33.51
MA	$15.46	$33.51
MD	$14.93	$33.43
ME	$15.46	$33.51
MI	$14.90	$33.51
MN	$14.19	$33.51
MO	$14.19	$33.51
MS	$14.77	$33.27
MT	$15.58	$33.51
NC	$14.77	$32.57
ND	$14.19	$33.51
NE	$14.19	$33.51
NH	$15.46	$32.40
NJ	$14.93	$32.40
NM	$14.74	$33.16
NV	$15.64	$33.51
NY	$14.93	$32.40
OH	$14.90	$33.43
OK	$14.74	$33.11
OR	$15.64	$33.51
PA	$14.93	$32.40
PR	$36.48	—
RI	$15.46	$32.40
SC	$14.77	$33.05
SD	$14.19	$33.51
TN	$14.77	$33.51
TX	$14.74	$31.86
UT	$15.58	$33.51
VA	$14.77	$33.43
VI	$32.31	—
VT	$15.46	$33.36
WA	$15.64	$33.51
WI	$14.90	$33.51
WV	$14.77	$33.43
WY	$15.58	$33.51

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

CO-50 medical necessity

Bill A7037 with confidence

MyMedi-AI scrubs whole claims against NCCI pairs, MUE limits, modifier rules, and PA flags before you submit — built for DME teams, no PHI stored on our servers.

Start free trial Run a CMS-0057-F readiness check

Prefer DIY compliance? Self-audit documentation kits for DME suppliers →

Building an AI agent? Try the agent API in the playground — free PA-required lookups, A7037 included, and starter credits via POST /bot-marketplace/register.