HCPCS Level II › A codes A6234 Hydrocolld drg <=16 w/o bdrHydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, 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 A6234 DMEPOS fee schedule, July 2026 (DME26-C) no modifier, surgical dressings (SD): non-rural $9.33 in the contiguous states; $9.33 to $11.19 in AK, HI, PR and VI; ceiling $9.33, floor $7.93 Physician Fee Schedule (CY 2026, RVU26D) Status P: bundled or excluded, no separate PFS payment.
Payer policies and prior authorization for A6234 Payer coverage policies that name A6234 A6234 appears in 2 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 Surgical Devices, Dressings, and Wound Care Supplies (0526) covered if criteria are met (range A6234-A6241) Aug 26, 2026 payer document
Medicaid fee-for-service Prior authorization required or conditional in CO, KY, LA, MA, OH, VA, WV.
AZ: $11.13 (dme), effective Oct 1, 2026 CO: $6.83 (chp_plus, non-facility), effective Jul 1, 2026 FL: $5.37 (dme), effective Jul 1, 2026 IL: $6.23 (dme), effective Jan 1, 2026 IN: $7.78 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2026 KS: $7.46 (default), effective Jul 1, 2026 KY: $6.24 (dme), effective Jan 1, 2026 LA: $4.21 (dme), effective Sep 1, 2021 MA: $7.60 (dme_rates), effective Mar 1, 2026 MD: $7.93 (dme), effective Apr 1, 2026 MS: $7.46 (comprehensive), effective Jul 1, 2026 ND: $11.51 (dme), effective Aug 1, 2026 NE: $8.16 (dme), effective Jul 1, 2026 NY: $5.75 (dme), effective Jul 1, 2026 OH: $4.80 (dme), effective Jan 1, 1997 OK: $9.33 (dme), effective Jan 1, 2026 TX: $6.24 (dmepos_tos_9_e_j_l_and_r, Home Health Dme, non-facility), effective Jul 1, 1997 VA: $8.40 (dme), effective Dec 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $7.01 (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.