`A9269` Programable ingest capsule

Programable, transient, orally ingested capsule, for use with external programmer, per month

Medicare coverage: Non-covered by statute
Status: active (October 2026 file)

Medicare pricing for A9269

Physician Fee Schedule (CY 2026, RVU26D)

Status N: non-covered service.

Payer policies and prior authorization for A9269

Payer coverage policies that name A9269

A9269 appears in 5 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Rhode Island, Capital Blue Cross, Premera Blue Cross.

Payer	Policy	Role in policy	Reviewed	Document
Aetna	Bowel Management Devices (0522)	not covered	Aug 18, 2026	payer document
Anthem	Ingestible Devices for the Treatment of Constipation (MED.00143)	unproven / investigational	Nov 6, 2025	payer document
Blue Cross & Blue Shield of Rhode Island	Ingestible Devices for the Treatment of Constipation	not covered	Jul 1, 2026	payer document
Capital Blue Cross	Experimental and Investigational Procedures (MP 4.002) Procedure codes: Gastroenterology	listed, no stance	Sep 1, 2026	payer 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.

ND: $0.00 (physician), effective Aug 1, 2026
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.

A9269 Programable ingest capsule