A9596 — Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie
A9596 is a HCPCS Level II code for gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie. 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 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 A9596 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
- 7 units MAI 3 — Date of Service Edit: Clinical · Prescribing Information
- outpatient
- 7 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 A9596
- Long descriptor
- Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie
- Short descriptor
- Gallium illuccix 1 millicure
- Added
- July 1, 2022
- 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 A9596
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If A9596 is not quite right, the correct code is very often within a few positions of it.
- A9588Fluciclovine f-18, diagnostic, 1 millicurie
- A9589Instillation, hexaminolevulinate hydrochloride, 100 mg
- A9590Iodine i-131, iobenguane, 1 millicurie
- A9591Fluoroestradiol f 18, diagnostic, 1 millicurie
- A9592Copper cu-64, dotatate, diagnostic, 1 millicurie
- A9593Gallium ga-68 psma-11, diagnostic, (ucsf), 1 millicurie
- A9594Gallium ga-68 psma-11, diagnostic, (ucla), 1 millicurie
- A9595Piflufolastat f-18, diagnostic, 1 millicurie
- A9597Positron emission tomography radiopharmaceutical, diagnostic, for tumor identification, not otherwise classified
- A9598Positron emission tomography radiopharmaceutical, diagnostic, for non-tumor identification, not otherwise classified
- A9599Radiopharmaceutical, diagnostic, for beta-amyloid positron emission tomography (pet) imaging, per study dose, not otherwise specifiedterminated
- A9600Strontium sr-89 chloride, therapeutic, per millicurie
- A9601Flortaucipir f 18 injection, diagnostic, 1 millicurie
- A9602Fluorodopa f-18, diagnostic, per millicurie
- A9603Injection, pafolacianine, 0.1 mg
- A9604Samarium sm-153 lexidronam, therapeutic, per treatment dose, up to 150 millicuries
Questions about A9596
What is HCPCS code A9596?
A9596 is a HCPCS Level II code for gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie. It sits in the Transportation, Medical & Surgical Supplies, Administrative section.
Does Medicare cover A9596?
The CMS HCPCS file marks A9596 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 A9596 paid under the physician fee schedule?
A9596 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.