HCPCS Level II › P codes P9016 Rbc leukocytes reducedRed blood cells, leukocytes reduced, each unit
Medicare coverage: Special coverage instructions apply Status: active (October 2026 file) Medically Unlikely Edits (effective October 1, 2026) Practitioner: max 3 units per day (clinical), rationale: Clinical: Data Outpatient hospital: max 12 units per day (clinical), rationale: Clinical: Data Medicare pricing for P9016 Physician Fee Schedule (CY 2026, RVU26D) Status E: excluded from the PFS by regulation.
Payer policies and prior authorization for P9016 Medicaid fee-for-service AZ: $74.01 (lab), effective Oct 1, 2026 IN: $203.90 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2026 KS: $65.25 (default, Exempt Physician), effective Jan 1, 2004 MS: $137.45 (comprehensive), effective Jul 1, 2026 ND: $0.00 (physician), effective Aug 1, 2026 OK: $136.54 (physician, non-facility), effective Jul 1, 2026 TX: $104.97 (certified_nurse_midwife_cnm, Certified Nurse Midwife (Cnm), facility), effective Mar 1, 2026 VA: $45.00 (medical), effective Jan 1, 1994 VT: $140.53 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $45.53 (kidneycenters), effective Jul 1, 2026 WY: $80.04 (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.