MyMedi-AI

A7522 — Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each

HCPCS Level II A-code · short descriptor: “Trach/laryn tube stainless”

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
Ostomy, tracheostomy & urological supplies
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 2026-10-25; 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.

A7522 Medicare fee schedule (October 2026)

Base (no modifier) Ostomy, tracheostomy & urological supplies

Medicare allowable ranges from $64.36 to $77.22 depending on state and rural status.

Former-CBA payment limits: ceiling $64.36 · floor $54.71

StateNon-ruralRural
AK$64.36—
AL$64.36—
AR$64.36—
AZ$64.36—
CA$64.36—
CO$64.36—
CT$64.36—
DC$64.36—
DE$64.36—
FL$64.36—
GA$64.36—
HI$64.36—
IA$64.36—
ID$64.36—
IL$64.36—
IN$64.36—
KS$64.36—
KY$64.36—
LA$64.36—
MA$64.36—
MD$64.36—
ME$64.36—
MI$64.36—
MN$64.36—
MO$64.36—
MS$64.36—
MT$64.36—
NC$64.36—
ND$64.36—
NE$64.36—
NH$64.36—
NJ$64.36—
NM$64.36—
NV$64.36—
NY$64.36—
OH$64.36—
OK$64.36—
OR$64.36—
PA$64.36—
PR$77.22—
RI$64.36—
SC$64.36—
SD$64.36—
TN$64.36—
TX$64.36—
UT$64.36—
VA$64.36—
VI$64.36—
VT$64.36—
WA$64.36—
WI$64.36—
WV$64.36—
WY$64.36—
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 A7522 at 1 unit per date of service (absolute). Units above the MUE deny — typically as CO-151. Rationale: Published Contractor Policy.

Common denial codes to watch

Related A-codes

Bill A7522 with confidence

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