A6266 Impreg gauze no h20/sal/yard

Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard

Medically Unlikely Edits (effective October 1, 2026)

Medicare pricing for A6266

DMEPOS fee schedule, July 2026 (DME26-C)

Physician Fee Schedule (CY 2026, RVU26D)

Status P: bundled or excluded, no separate PFS payment.

Payer policies and prior authorization for A6266

1 of 1 payer prior-auth lists that name A6266 require prior authorization or set conditions: Medicare.

PayerPlanStatePrior authConditionsSinceSource
MedicareDMEPOS Master List (items potentially subject to PA)Allprior auth under conditionsOn the Master List; PA only if CMS selects it for the Required ListJul 30, 2026Master List of DMEPOS Items Potentially Subject to Face-to-Face Encounter and Written Order Prior to Delivery and/or Prior Authorization Requirements

Payer coverage policies that name A6266

A6266 appears in 3 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaDialysis (0541)covered if criteria are met (range A6010-A6457)Aug 26, 2026payer document
AetnaSurgical Devices, Dressings, and Wound Care Supplies (0526)covered if criteria are metAug 26, 2026payer document
AetnaUrological Supplies (0533)not covered (range A6266-A6404)Jul 30, 2026payer document

Recent prior-auth changes

  • Jul 1, 2023: PA removed, Blue Shield of California Promise Health Plan

Medicaid fee-for-service

Prior authorization required or conditional in CO, KY, LA, MA, OH, VA, WV.

  • AZ: $3.25 (dme), effective Oct 1, 2026
  • CO: $2.16 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $1.56 (dme), effective Jul 1, 2026
  • IL: $1.82 (dme), effective Jan 1, 2026
  • IN: $2.27 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2026
  • KS: $2.18 (default), effective Jul 1, 2026
  • KY: $1.83 (dme), effective Jan 1, 2026
  • LA: $1.23 (dme), effective Sep 1, 2021
  • MA: $2.22 (dme_rates), effective Mar 1, 2026
  • MD: $2.31 (dme), effective Apr 1, 2026
  • MS: $2.18 (comprehensive), effective Jul 1, 2026
  • ND: $3.39 (dme), effective Aug 1, 2026
  • NE: $2.38 (dme), effective Jul 1, 2026
  • NY: $2.04 (dme), effective Jul 1, 2026
  • OH: $1.75 (dme), effective Aug 1, 1997
  • OK: $2.72 (dme), effective Jan 1, 2026
  • TX: $1.83 (dmepos_tos_9_e_j_l_and_r, Home Health Dme, non-facility), effective Jul 1, 1997
  • VA: $2.45 (dme), effective Dec 1, 2026
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $2.07 (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.