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A9500 Tc99m sestamibi

What A9500 is

Technetium tc-99m sestamibi, diagnostic, per study dose

HCPCS Level II long description, CMS October 2026 file. See the A codes page for the full section.

Medicare payment for A9500 (CY2026)

This code has no Physician Fee Schedule rate: Carrier-priced - the Medicare contractor sets the price. It may be paid under a different fee schedule (clinical laboratory, DMEPOS, anesthesia) or not paid at all - check the relevant CMS schedule.

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Medically Unlikely Edit (MUE)

Medicare caps A9500 at 3 units per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Clinical: Society Comment. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with A9500? These codes are bundled into it

A9500 is a Column 1 code in 1 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 codeShort descriptionModifier indicator
A9512Tc99m pertechnetate1 - modifier may bypassCheck pair

A9500 is bundled into these codes

A9500 appears as a Column 2 code in 53 active edits. Reported with one of these Column 1 codes on the same date of service, A9500 is the code that denies.

Column 1 codeShort descriptionModifier indicator
0868THi-res gastric ep mapping0Check pair
38792Ra tracer id of sentinl node0Check pair
78015Thyroid met imaging0Check pair
78016Thyroid met imaging/studies0Check pair
78018Thyroid met imaging body0Check pair
78102Bone marrow imaging ltd0Check pair
78140Red cell sequestration0Check pair
78195Lymph system imaging0Check pair
78201Liver imaging static only0Check pair
78202Liver imaging with vasc flow0Check pair
78215Lvr&spleen img static only0Check pair
78216Lvr&spleen img w/vasc flow0Check pair
78226Hepatobiliary system imaging0Check pair
78227Hepatobil syst image w/drug0Check pair
78264Gastric emptying img study0Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.