`A9180` Lice treatment, topical

Pediculosis (lice infestation) treatment, topical, for administration by patient/caretaker

Medicare coverage: Not payable by Medicare
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 0 units per day (clinical), rationale: CMS Policy

Medicare pricing for A9180

Physician Fee Schedule (CY 2026, RVU26D)

Status I: not valid for Medicare (Medicare uses another code).

Payer policies and prior authorization for A9180

Payer coverage policies that name A9180

A9180 appears in 1 coverage policy from Premera Blue Cross.

Payer	Policy	Role in policy	Reviewed	Document
Premera Blue Cross	Non-covered Services and Procedures Page \| 12 of 30 \| ∞	listed, no stance	Jun 1, 2026	payer document

Medicaid fee-for-service

Prior authorization required or conditional in IN.

VT: $0.00 (outpatient_hospital_opps), effective Feb 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.

A9180 Lice treatment, topical