HCPCS Level II › A codes A9521 Tc99m exametazimeTechnetium tc-99m exametazime, diagnostic, per study dose, up to 25 millicuries
Medicare coverage: Carrier judgment Status: active (October 2026 file) Medically Unlikely Edits (effective October 1, 2026) Practitioner: max 2 units per day (clinical), rationale: Code Descriptor / CPT Instruction Outpatient hospital: max 2 units per day (clinical), rationale: Code Descriptor / CPT Instruction Medicare pricing for A9521 Physician Fee Schedule (CY 2026, RVU26D) Status C: contractor-priced by the MAC.
Payer policies and prior authorization for A9521 Payer coverage policies that name A9521 A9521 appears in 1 coverage policy from Aetna.
Payer Policy Role in policy Reviewed Document Aetna Transthyretin-Mediated (ATTR) Amyloidosis (0939) listed, no stance (range A9510-A9568) Aug 10, 2026 payer document
Medicaid fee-for-service Prior authorization required or conditional in IN.
AZ: $641.87 (outpatient_hospital), effective Oct 1, 2025 KY: $927.71 (asc), effective Jan 1, 2026 MS: $1756.82 (comprehensive), effective Jul 1, 2026 ND: $1297.32 (physician), effective Aug 1, 2026 NE: $1830.52 (injectables), effective Jul 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Apr 1, 2026 WA: $1953.92 (physician, facility), 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.