A9513 HCPCS code: Lutetium lu 177, dotatate, therapeutic, 1 millicurie
A9513 is the HCPCS Level II code for lutetium lu 177, dotatate, therapeutic, 1 millicurie. In 2024 Medicare paid an average of $250.19 per service for A9513 across 91,476 services. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 200 per day on outpatient hospital claims. Medicare volume rose 41% from 2022 to 2024 (65,051 to 91,476 services). In 2024, about 98 clinicians billed Medicare for A9513 for 199 beneficiaries; Texas, Arizona, Maryland accounted for 61% of services.
Code details
| Field | Value |
|---|---|
| Section | A codes — Transportation, medical/surgical supplies and miscellaneous |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 57 |
| BETOS category | I1E |
| Added | 2019-01-01 |
| Last action effective | 2025-01-01 |
Who bills A9513 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 98 |
| Medicare beneficiaries | 199 |
| States with claims | 7 |
| Share of services in top 3 states (Texas, Arizona, Maryland) | 61% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A9513, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 65,051 | 152 | $299.54 | $238.98 |
| 2023 | 70,155 | 152 | $302.22 | $240.77 |
| 2024 | 91,476 | 199 | $314.03 | $250.19 |
States with the most A9513 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Texas | 17,727 | $258.16 |
| Arizona | 9,111 | $251.63 |
| Maryland | 8,681 | $252.86 |
| Florida | 6,997 | $246.88 |
| Arkansas | 6,526 | $257.29 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 200 | Prescribing Information |
| practitioner claims | 200 | Prescribing Information |
What changed for A9513
- 2019-01-01: A9513 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 A9513?
A9513 is the HCPCS Level II code for lutetium lu 177, dotatate, therapeutic, 1 millicurie. Short descriptor: "Lutetium lu 177 dotatat ther".
How much does Medicare pay for A9513?
In 2024, the average Medicare payment was $250.19 per service (average allowed $314.03).
Does Medicare cover A9513?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of A9513 can be billed per day?
200 on outpatient hospital claims; 200 on practitioner claims (NCCI medically unlikely edits).
Related A95 codes
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- A9503 — Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries
- A9504 — Technetium tc-99m apcitide, diagnostic, per study dose, up to 20 millicuries
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- A9507 — Indium in-111 capromab pendetide, diagnostic, per study dose, up to 10 millicuries
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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 A9513
- Watch A9513 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A9513
Sources: CMS HCPCS Level II release October 2025; 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.