A9513 — Lutetium lu 177, dotatate, therapeutic, 1 millicurie
A9513 is a HCPCS Level II code for lutetium lu 177, dotatate, therapeutic, 1 millicurie. It belongs to the Transportation, Medical & Surgical Supplies, Administrative section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Special coverage instructions apply
There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
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 statusX
Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.
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 A9513 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
- 200 units MAI 3 — Date of Service Edit: Clinical · Prescribing Information
- outpatient
- 200 units MAI 3 — Date of Service Edit: Clinical · Prescribing Information
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 A9513
- Long descriptor
- Lutetium lu 177, dotatate, therapeutic, 1 millicurie
- Short descriptor
- Lutetium lu 177 dotatat ther
- Added
- January 1, 2019
- 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 A9513
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If A9513 is not quite right, the correct code is very often within a few positions of it.
- 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
- A9510Technetium tc-99m disofenin, diagnostic, per study dose, up to 15 millicuries
- A9512Technetium tc-99m pertechnetate, diagnostic, per millicurie
- A9515Choline c-11, diagnostic, per study dose up to 20 millicuries
- A9516Iodine i-123 sodium iodide, diagnostic, per 100 microcuries, up to 999 microcuries
- A9517Iodine i-131 sodium iodide capsule(s), therapeutic, per millicurie
- A9520Technetium tc-99m tilmanocept, diagnostic, up to 0.5 millicuries
- A9521Technetium tc-99m exametazime, diagnostic, per study dose, up to 25 millicuries
- A9524Iodine i-131 iodinated serum albumin, diagnostic, per 5 microcuries
- A9526Nitrogen n-13 ammonia, diagnostic, per study dose, up to 40 millicuries
- A9527Iodine i-125, sodium iodide solution, therapeutic, per millicurie
Questions about A9513
What is HCPCS code A9513?
A9513 is a HCPCS Level II code for lutetium lu 177, dotatate, therapeutic, 1 millicurie. It sits in the Transportation, Medical & Surgical Supplies, Administrative section.
Does Medicare cover A9513?
The CMS HCPCS file marks A9513 as "Special coverage instructions apply". There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
How is A9513 paid under the physician fee schedule?
A9513 carries PFS status code X. Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.