HCPCS Level II › Q codes Q9953 Inj fe-based mr contrast,1mlInjection, iron-based magnetic resonance contrast agent, per ml
Medicare coverage: Special coverage instructions apply Status: active (October 2026 file) Medically Unlikely Edits (effective October 1, 2026) Practitioner: max 10 units per day (clinical), rationale: Prescribing Information Outpatient hospital: max 10 units per day (clinical), rationale: Prescribing Information Medicare pricing for Q9953 Physician Fee Schedule (CY 2026, RVU26D) Status E: excluded from the PFS by regulation.
Payer policies and prior authorization for Q9953 Payer coverage policies that name Q9953 Q9953 appears in 1 coverage policy from Aetna.
Payer Policy Role in policy Reviewed Document Aetna Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) of the Spine (0236) covered if criteria are met Apr 9, 2026 payer document
Medicaid fee-for-service Prior authorization required or conditional in IN.
CO: $35.83 (health_first_colorado), effective Jul 1, 2026 KY: $0.00 (asc), effective Jan 1, 2026 ND: $0.00 (physician), effective Aug 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $62.05 (professional_administered_drugs), effective Jul 1, 2026 WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), 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.