A7036 HCPCS code: Chinstrap used with positive airway pressure device
A7036 is the HCPCS Level II code for chinstrap used with positive airway pressure device. The 2026 Medicare DMEPOS fee schedule pays $12.95 to $18.48 (NU, new equipment, purchased) depending on the state. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 1 per day on DME suppliers. Medicare volume rose 12% from 2022 to 2024 (213,731 to 239,336 services). In 2024, 3,894 suppliers billed Medicare for A7036 (purchases), serving 190,023 beneficiaries; California, Florida, Texas accounted for 27% of services. Its average fee ranks 14 of 37 A70 codes billed NU (family range $0.71–$172.96); rural fees run 31% higher.
Code details
| Field | Value |
|---|---|
| Section | A codes — Transportation, medical/surgical supplies and miscellaneous |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 32 — DMEPOS: inexpensive or routinely purchased item |
| BETOS category | D1E — Other durable medical equipment |
| Added | 2003-01-01 |
| Last action effective | 2003-01-01 |
2026 Medicare DMEPOS fee schedule for A7036
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| NU | new equipment, purchased | $12.95 | $18.48 | — | — |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | NU | $15.30 | — |
| AL | NU | $13.32 | $17.11 |
| AR | NU | $13.32 | $17.02 |
| AZ | NU | $13.00 | $18.52 |
| CA | NU | $13.70 | $18.52 |
| CO | NU | $13.08 | $17.07 |
| CT | NU | $13.80 | $18.52 |
| DC | NU | $12.95 | $16.84 |
| DE | NU | $12.95 | $18.52 |
| FL | NU | $13.32 | $16.84 |
| GA | NU | $13.32 | $16.84 |
| HI | NU | $15.87 | — |
| IA | NU | $12.97 | $18.52 |
| ID | NU | $13.08 | $18.52 |
| IL | NU | $13.58 | $16.84 |
| IN | NU | $13.58 | $16.87 |
| KS | NU | $12.97 | $18.52 |
| KY | NU | $13.32 | $16.93 |
| LA | NU | $13.32 | $17.29 |
| MA | NU | $13.80 | $18.52 |
| MD | NU | $12.95 | $16.84 |
| ME | NU | $13.80 | $18.52 |
| MI | NU | $13.58 | $16.84 |
| MN | NU | $12.97 | $16.95 |
| MO | NU | $12.97 | $18.52 |
| MS | NU | $13.32 | $17.02 |
| MT | NU | $13.08 | $18.52 |
| NC | NU | $13.32 | $16.84 |
| ND | NU | $12.97 | $18.52 |
| NE | NU | $12.97 | $18.52 |
| NH | NU | $13.80 | $18.52 |
| NJ | NU | $12.95 | $18.52 |
| NM | NU | $13.00 | $16.97 |
| NV | NU | $13.70 | $18.52 |
| NY | NU | $12.95 | $18.52 |
| OH | NU | $13.58 | $16.84 |
| OK | NU | $13.00 | $16.96 |
| OR | NU | $13.70 | $18.52 |
| PA | NU | $12.95 | $18.52 |
| PR | NU | $18.25 | — |
| RI | NU | $13.80 | $18.52 |
| SC | NU | $13.32 | $16.93 |
| SD | NU | $12.97 | $18.52 |
| TN | NU | $13.32 | $17.18 |
| TX | NU | $13.00 | $16.84 |
| UT | NU | $13.08 | $18.52 |
| VA | NU | $13.32 | $16.84 |
| VI | NU | $18.48 | — |
| VT | NU | $13.80 | $18.52 |
| WA | NU | $13.70 | $18.52 |
| WI | NU | $13.58 | $16.87 |
| WV | NU | $13.32 | $16.84 |
| WY | NU | $13.08 | $18.52 |
How the A7036 fee compares
| Measure | Value |
|---|---|
| Rank among 37 A70 codes billed NU (lowest = 1) | 14 |
| Family fee range (average of state fees) | $0.71–$172.96 |
| Rural fee uplift | 30.8% |
Who bills A7036 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 3,894 |
| Referring clinicians | 44,877 |
| Medicare beneficiaries | 190,023 |
| States with claims | 54 |
| Share of services in top 3 states (California, Florida, Texas) | 27% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 3,984 | 168,600 |
| 2023 | 3,958 | 178,844 |
| 2024 | 3,894 | 190,023 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A7036, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 213,731 | 168,600 | $12.42 | $9.32 |
| 2023 | 224,742 | 178,844 | $13.33 | $10.03 |
| 2024 | 239,336 | 190,023 | $13.31 | $10.00 |
States with the most A7036 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 25,949 | $10.14 |
| Florida | 21,029 | $9.29 |
| Texas | 18,335 | $9.70 |
| Washington | 8,809 | $10.53 |
| Pennsylvania | 8,614 | $9.60 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 1 | Published Contractor Policy |
What changed for A7036
- 2026-01-01: Average state fee (NU) rose 2.6%: $13.22 to $13.57
- 2003-01-01: A7036 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code A7036?
A7036 is the HCPCS Level II code for chinstrap used with positive airway pressure device. Short descriptor: "Pos airway press chinstrap".
How much does Medicare pay for A7036?
Under the 2026 DMEPOS fee schedule, non-rural state fees are NU (new equipment, purchased): $12.95–$18.48. Rural fees can be higher.
Does Medicare cover A7036?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for A7036 change in 2026?
The average non-rural state fee for NU moved from $13.22 in 2025 to $13.57 in 2026 (+2.6%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of A7036 can be billed per day?
1 on DME suppliers (NCCI medically unlikely edits).
Related A70 codes
- A7000 — Canister, disposable, used with suction pump, each ($9.24–$13.39)
- A7001 — Canister, non-disposable, used with suction pump, each ($40.06–$47.58)
- A7002 — Tubing, used with suction pump, each ($3.87–$5.47)
- A7003 — Administration set, with small volume nonfiltered pneumatic nebulizer, disposable ($1.86–$3.26)
- A7004 — Small volume nonfiltered pneumatic nebulizer, disposable ($1.51–$2.08)
- A7005 — Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable ($11.77–$29.20)
- A7006 — Administration set, with small volume filtered pneumatic nebulizer ($8.19–$14.94)
- A7007 — Large volume nebulizer, disposable, unfilled, used with aerosol compressor ($3.47–$5.87)
- A7008 — Large volume nebulizer, disposable, prefilled, used with aerosol compressor ($12.46–$18.09)
- A7009 — Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer ($54.00–$66.77)
- A7010 — Corrugated tubing, disposable, used with large volume nebulizer, 100 feet ($17.61–$27.19)
- A7011 — Corrugated tubing, non-disposable, used with large volume nebulizer, 10 feet
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under A7036
- Watch A7036 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A7036
Sources: CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.