HCPCS Level II › A codes A6198 Alginate dressing > 48 sq inAlginate or other fiber gelling dressing, wound cover, sterile, pad size more than 48 sq. in., each dressing
Medicare coverage: Special coverage instructions apply Status: active (October 2026 file) Medically Unlikely Edits (effective October 1, 2026) Practitioner: max 0 units per day (clinical), rationale: CMS Policy Medicare pricing for A6198 Physician Fee Schedule (CY 2026, RVU26D) Status P: bundled or excluded, no separate PFS payment.
Payer policies and prior authorization for A6198 Payer coverage policies that name A6198 A6198 appears in 3 coverage policies from Aetna.
Payer Policy Role in policy Reviewed Document Aetna Dialysis (0541) covered if criteria are met (range A6010-A6457) Aug 26, 2026 payer document Aetna Skin and Soft Tissue Substitutes (0244) not covered (range A6196-A6199) Jul 29, 2026 payer document Aetna Surgical Devices, Dressings, and Wound Care Supplies (0526) covered if criteria are met (range A6196-A6199) Aug 26, 2026 payer document
Medicaid fee-for-service Prior authorization required or conditional in CO, IL, KY, LA, MA, OH, VA, WV.
CO: $35.58 (health_first_colorado), effective Jul 1, 2026 IN: $9.78 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2026 KS: $20.00 (default), effective Sep 1, 2007 KY: $5.78 (dme), effective Jan 1, 2026 LA: $8.43 (dme), effective Sep 1, 2021 MD: $22.44 (dme), effective Apr 1, 2026 NY: $14.67 (dme), effective Jul 1, 2026 OH: $31.40 (dme), effective Jul 26, 2007 TX: $19.42 (dmepos_tos_9_e_j_l_and_r, Home Health Dme, non-facility), effective Apr 1, 2017 VA: $20.45 (dme), effective Dec 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $18.01 (medical_equipment_supplies), effective Jul 1, 2026 WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), effective Apr 1, 2026 From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.