A9528 HCPCS code: Iodine i-131 sodium iodide capsule(s), diagnostic, per millicurie
A9528 is the HCPCS Level II code for iodine i-131 sodium iodide capsule(s), diagnostic, per millicurie. In 2024 Medicare paid an average of $89.41 per service for A9528 across 260 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 10 per day on outpatient hospital claims. Medicare volume fell 18% from 2022 to 2024 (317 to 260 services). In 2024, about 41 clinicians billed Medicare for A9528 for 91 beneficiaries.
Code details
| Field | Value |
|---|---|
| Section | A codes — Transportation, medical/surgical supplies and miscellaneous |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 57 |
| BETOS category | I1E |
| Added | 2004-01-01 |
| Last action effective | 2006-01-01 |
Who bills A9528 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 41 |
| Medicare beneficiaries | 91 |
| States with claims | 2 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A9528, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 317 | 145 | $88.78 | $70.84 |
| 2023 | 455 | 132 | $75.64 | $60.05 |
| 2024 | 260 | 91 | $112.25 | $89.41 |
States with the most A9528 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Mississippi | 88 | $100.61 |
| California | 36 | $61.00 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 10 | Clinical: Data |
| practitioner claims | 10 | Clinical: Data |
What changed for A9528
- 2004-01-01: A9528 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 A9528?
A9528 is the HCPCS Level II code for iodine i-131 sodium iodide capsule(s), diagnostic, per millicurie. Short descriptor: "Iodine i-131 iodide cap, dx".
How much does Medicare pay for A9528?
In 2024, the average Medicare payment was $89.41 per service (average allowed $112.25).
Does Medicare cover A9528?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of A9528 can be billed per day?
10 on outpatient hospital claims; 10 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
- A9508 — Iodine i-131 iobenguane sulfate, diagnostic, per 0.5 millicurie
- A9509 — Iodine i-123 sodium iodide, diagnostic, per millicurie
- A9510 — Technetium tc-99m disofenin, diagnostic, per study dose, up to 15 millicuries
- A9512 — Technetium tc-99m pertechnetate, diagnostic, per millicurie
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Next steps
- Run a reimbursement report for a device billed under A9528
- Watch A9528 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A9528
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.