HCPCS Level II › C codes C9460 Injection, cangrelorInjection, cangrelor, 1 mg
Medicare coverage: Special coverage instructions apply Status: active (October 2026 file) Medically Unlikely Edits (effective October 1, 2026) Practitioner: max 1 units per day (clinical), rationale: Clinical: CMS Workgroup Outpatient hospital: max 100 units per day (clinical), rationale: Prescribing Information Payer policies and prior authorization for C9460 Medicaid fee-for-service Prior authorization required or conditional in WA.
AZ: $18.94 (asc), effective Oct 1, 2026 IN: $18.75 (professional, Advanced Practice Nurse (85%), non-facility), effective Apr 1, 2026 KS: $20.02 (asc, facility), effective Apr 1, 2025 KY: $19.94 (asc), effective Jan 1, 2026 MS: $15.85 (comprehensive, facility), effective Oct 1, 2025 ND: $0.00 (physician), effective Aug 1, 2026 NE: $22.44 (injectables), effective Jul 1, 2026 TX: $21.43 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, non-facility), effective Sep 1, 2026 VT: $15.18 (outpatient_hospital_opps), effective Feb 1, 2026 WY: $8.67 (outpatient_hospital_apc, Ambulatory Surgical Centers), 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.