`P9046` Albumin (human), 25%, 20 ml

Infusion, albumin (human), 25%, 20 ml

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

Medically Unlikely Edits (effective October 1, 2026)

Practitioner: max 25 units per day (clinical), rationale: Clinical: Data
Outpatient hospital: max 40 units per day (clinical), rationale: Clinical: Data

Medicare pricing for P9046

Medicare Part B drug payment limit (ASP, October 2026)

P9046 payment limit: $21.33 per 20 ML, effective October 1, 2026 through December 31, 2026, based on 2Q26 ASP data. Coinsurance 20%. Paid at 95% of AWP (blood product).

Physician Fee Schedule (CY 2026, RVU26D)

Status X: statutory exclusion, not paid under the PFS.

Payer policies and prior authorization for P9046

Medicaid fee-for-service

AZ: $20.17 (asc), effective Oct 1, 2024
CO: $29.86 (chp_plus, non-facility), effective Jul 1, 2026
IN: $16.70 (professional, Advanced Practice Nurse (85%), non-facility), effective Apr 1, 2026
KS: $21.33 (default), effective Jul 1, 2026
KY: $21.23 (asc), effective Jan 1, 2026
MS: $16.98 (comprehensive, facility), effective Oct 1, 2025
NE: $21.33 (injectables), effective Jul 1, 2026
OK: $19.97 (physician, non-facility), effective Jul 1, 2026
TX: $21.23 (physician, Physician, non-facility), effective Mar 1, 2024
VA: $21.33 (medical), effective Jul 1, 2026
VT: $16.13 (outpatient_hospital_opps), effective Feb 1, 2026
WA: $21.33 (kidneycenters), effective Jul 1, 2026
WY: $9.19 (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.

P9046 Albumin (human), 25%, 20 ml