A9501 — Technetium tc-99m teboroxime, diagnostic, per study dose
A9501 is a HCPCS Level II code for technetium tc-99m teboroxime, diagnostic, per study dose. It belongs to the Transportation, Medical & Surgical Supplies, Administrative section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusC
Contractor-priced. Your MAC establishes the RVUs and the payment amount case by case, usually after reviewing documentation. There is no national amount to compute.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
Medically Unlikely Edits — units per day
The most units of A9501 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 1 unit MAI 3 — Date of Service Edit: Clinical · Clinical: Data
- outpatient
- 1 unit MAI 3 — Date of Service Edit: Clinical · Clinical: Data
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for A9501
- Long descriptor
- Technetium tc-99m teboroxime, diagnostic, per study dose
- Short descriptor
- Technetium tc-99m teboroxime
- Added
- January 1, 2008
- BETOS
- I1E
- Pricing indicator
- 57 — Other
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Other carrier priced.
Codes adjacent to A9501
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If A9501 is not quite right, the correct code is very often within a few positions of it.
- A9285Inversion/eversion correction device
- A9286Hygienic item or device, disposable or non-disposable, any type, each
- A9291Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment
- A9292Prescription digital visual therapy, software-only, fda cleared, per course of treatment
- A9293Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)
- A9294Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment
- A9300Exercise equipment
- A9500Technetium tc-99m sestamibi, diagnostic, per study dose
- A9502Technetium tc-99m tetrofosmin, diagnostic, per study dose
- A9503Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries
- A9504Technetium tc-99m apcitide, diagnostic, per study dose, up to 20 millicuries
- A9505Thallium tl-201 thallous chloride, diagnostic, per millicurie
- A9506Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible
- A9507Indium in-111 capromab pendetide, diagnostic, per study dose, up to 10 millicuries
- A9508Iodine i-131 iobenguane sulfate, diagnostic, per 0.5 millicurie
- A9509Iodine i-123 sodium iodide, diagnostic, per millicurie
Questions about A9501
What is HCPCS code A9501?
A9501 is a HCPCS Level II code for technetium tc-99m teboroxime, diagnostic, per study dose. It sits in the Transportation, Medical & Surgical Supplies, Administrative section.
Does Medicare cover A9501?
The CMS HCPCS file marks A9501 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
How is A9501 paid under the physician fee schedule?
A9501 carries PFS status code C. Contractor-priced. Your MAC establishes the RVUs and the payment amount case by case, usually after reviewing documentation. There is no national amount to compute.