HCPCS Level II › P codes P9043 Plasma protein fract,5%,50mlInfusion, plasma protein fraction (human), 5%, 50 ml
Medicare coverage: Special coverage instructions apply Status: active (October 2026 file) Medically Unlikely Edits (effective October 1, 2026) Practitioner: max 5 units per day (clinical), rationale: Prescribing Information Outpatient hospital: max 10 units per day (clinical), rationale: Prescribing Information Medicare pricing for P9043 Physician Fee Schedule (CY 2026, RVU26D) Status X: statutory exclusion, not paid under the PFS.
Payer policies and prior authorization for P9043 Medicaid fee-for-service AZ: $6.46 (outpatient_hospital), effective Oct 1, 2025 CO: $16.47 (chp_plus, non-facility), effective Jul 1, 2026 IN: $12.28 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2026 KS: $16.89 (default, Exempt Physician), effective Mar 1, 2019 MS: $6.03 (comprehensive), effective Jul 1, 2026 OK: $9.57 (physician, non-facility), effective Jul 1, 2026 TX: $22.52 (physician, Physician, non-facility), effective Nov 1, 2015 VA: $8.24 (medical), effective Apr 1, 2010 VT: $6.16 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $4.50 (kidneycenters), effective Jul 1, 2026 WY: $3.51 (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.