A9569 HCPCS code: Technetium tc-99m exametazime labeled autologous white blood cells, diagnostic, per study dose
A9569 is the HCPCS Level II code for technetium tc-99m exametazime labeled autologous white blood cells, diagnostic, per study dose. In 2024 Medicare paid an average of $1,607.78 per service for A9569 across 44 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 1 per day on outpatient hospital claims. Medicare volume fell 28% from 2022 to 2024 (61 to 44 services). In 2024, about 26 clinicians billed Medicare for A9569 for 44 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 | 2008-01-01 |
| Last action effective | 2025-01-01 |
Who bills A9569 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 26 |
| Medicare beneficiaries | 44 |
| States with claims | 1 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A9569, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 61 | 61 | $1,930.61 | $1,542.79 |
| 2023 | 50 | 50 | $1,850.56 | $1,476.43 |
| 2024 | 44 | 44 | $2,012.06 | $1,607.78 |
States with the most A9569 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 19 | $1,416.95 |
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 A9569
- 2008-01-01: A9569 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 A9569?
A9569 is the HCPCS Level II code for technetium tc-99m exametazime labeled autologous white blood cells, diagnostic, per study dose. Short descriptor: "Technetium tc-99m auto wbc".
How much does Medicare pay for A9569?
In 2024, the average Medicare payment was $1,607.78 per service (average allowed $2,012.06).
Does Medicare cover A9569?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of A9569 can be billed per day?
1 on outpatient hospital claims; 1 on practitioner claims (NCCI medically unlikely edits).
Related A95 codes
- A9500 — Technetium tc-99m sestamibi, diagnostic, per study dose
- A9501 — Technetium tc-99m teboroxime, diagnostic, per study dose
- A9502 — Technetium tc-99m tetrofosmin, diagnostic, per study dose
- 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
- A9505 — Thallium tl-201 thallous chloride, diagnostic, per millicurie
- A9506 — Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible
- 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 A9569
- Watch A9569 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A9569
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.