`A9580` Sodium fluoride f-18

Sodium fluoride f-18, diagnostic, per study dose, up to 30 millicuries

Medicare coverage: Carrier judgment
Status: active (October 2026 file)

Medically Unlikely Edits (effective October 1, 2026)

Practitioner: max 1 units per day (clinical), rationale: Nature of Service/Procedure
Outpatient hospital: max 1 units per day (clinical), rationale: Nature of Service/Procedure

Medicare pricing for A9580

Physician Fee Schedule (CY 2026, RVU26D)

Status C: contractor-priced by the MAC.

Payer policies and prior authorization for A9580

1 of 1 payer prior-auth lists that name A9580 require prior authorization or set conditions: UnitedHealthcare Community Plan.

Payer	Plan	State	Prior auth	Conditions	Since	Source
UnitedHealthcare Community Plan	Louisiana Medicaid (Healthy Louisiana)	LA	prior auth required		Jan 1, 2026	Prior authorization requirements for UnitedHealthcare Community Plan of Louisiana

Payer coverage policies that name A9580

A9580 appears in 3 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi.

Payer	Policy	Role in policy	Reviewed	Document
Aetna	Positron Emission Tomography (PET) (0071)	covered if criteria are met	Sep 14, 2026	payer document
Blue Cross & Blue Shield of Mississippi	Miscellaneous Noncardiac Nononcologic Applications Of Fluorine 18 Fluorodeoxyglucose Positron Emission Tomography	covered if criteria are met		payer document
Blue Cross & Blue Shield of Mississippi	Oncologic Applications Of Positron Emission Tomography Pet Scanning	covered if criteria are met		payer document

Medicaid fee-for-service

AZ: $300.00 (outpatient_hospital), effective Jan 1, 2026
CO: $225.49 (health_first_colorado), effective Jul 1, 2026
IN: $0.00 (professional, facility), effective Nov 10, 2017
KY: $0.00 (asc), effective Jan 1, 2026
LA: $32.95 (professional), effective Feb 1, 2018
NE: $320.40 (injectables), effective Jul 1, 2026
OK: $0.00 (physician, non-facility), effective Jul 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.

A9580 Sodium fluoride f-18