Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each
Medicare coverage: Carrier judgment
Status: active (October 2026 file)
Medically Unlikely Edits (effective October 1, 2026)
Practitioner: max 0 units per day (clinical), rationale: CMS Policy
Outpatient hospital: max 1 units per day (clinical), rationale: Nature of Equipment
DME supplier: max 1 units per day (clinical), rationale: Published Contractor Policy
Medicare pricing for A7521
DMEPOS fee schedule, July 2026 (DME26-C)
no modifier, ostomy, tracheostomy and urological (OS): non-rural $67.04 in the contiguous states; $67.04 to $80.49 in AK, HI, PR and VI; ceiling $67.04, floor $56.98
Physician Fee Schedule (CY 2026, RVU26D)
Status X: statutory exclusion, not paid under the PFS.
Payer policies and prior authorization for A7521
Payer coverage policies that name A7521
A7521 appears in 3 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi.
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.