A9291 HCPCS code: Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment
A9291 is the HCPCS Level II code for prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment. 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 outpatient hospital claims.
Code details
| Field | Value |
|---|---|
| Section | A codes — Transportation, medical/surgical supplies and miscellaneous |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 99 |
| BETOS category | Z2 |
| Added | 2022-04-01 |
| Last action effective | 2022-10-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 1 | Code Descriptor / CPT Instruction |
| practitioner claims | 1 | Code Descriptor / CPT Instruction |
What changed for A9291
- 2022-04-01: A9291 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 A9291?
A9291 is the HCPCS Level II code for prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment. Short descriptor: "Pres dig cog behav thera fda".
Does Medicare cover A9291?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of A9291 can be billed per day?
1 on outpatient hospital claims; 1 on practitioner claims (NCCI medically unlikely edits).
Related A92 codes
- A9268 — Programmer for transient, orally ingested capsule
- A9269 — Programable, transient, orally ingested capsule, for use with external programmer, per month
- A9270 — Non-covered item or service
- A9272 — Wound suction, disposable, includes dressing, all accessories and components, any type, each
- A9273 — Cold or hot fluid bottle, ice cap or collar, heat and/or cold wrap, any type
- A9274 — External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories
- A9275 — Home glucose disposable monitor, includes test strips
- A9276 — Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply
- A9277 — Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system
- A9278 — Receiver (monitor); external, for use with non-durable medical equipment interstitial continuous glucose monitoring system
- A9279 — Monitoring feature/device, stand-alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified
- A9280 — Alert or alarm device, not otherwise classified
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Next steps
- Run a reimbursement report for a device billed under A9291
- Watch A9291 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A9291
Sources: CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule; 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.