HCPCS Level II › P codes P9052 Platelets, hla-m, l/r, unitPlatelets, hla-matched leukocytes reduced, apheresis/pheresis, each unit
Medicare coverage: Special coverage instructions apply Status: active (October 2026 file) Medically Unlikely Edits (effective October 1, 2026) Practitioner: max 2 units per day (clinical), rationale: Clinical: CMS Workgroup Outpatient hospital: max 3 units per day (clinical), rationale: Clinical: Data Medicare pricing for P9052 Physician Fee Schedule (CY 2026, RVU26D) Status X: statutory exclusion, not paid under the PFS.
Payer policies and prior authorization for P9052 Medicaid fee-for-service AZ: $583.76 (outpatient_hospital), effective Oct 1, 2021 IN: $779.78 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2026 KS: $38.25 (default, Exempt Physician), effective Jan 1, 2004 MS: $526.31 (comprehensive), effective Jul 1, 2026 ND: $0.00 (physician), effective Aug 1, 2026 OK: $468.14 (physician, non-facility), effective Jul 1, 2026 TX: $468.14 (physician, Physician, non-facility), effective Mar 1, 2026 VT: $538.13 (outpatient_hospital_opps), effective Feb 1, 2026 WY: $306.49 (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.