A9589 HCPCS code: Instillation, hexaminolevulinate hydrochloride, 100 mg
A9589 is the HCPCS Level II code for instillation, hexaminolevulinate hydrochloride, 100 mg. In 2024 Medicare paid an average of $1,043.13 per service for A9589 across 175 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 74% from 2022 to 2024 (676 to 175 services). In 2024, about 28 clinicians billed Medicare for A9589 for 130 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 | 2019-01-01 |
| Last action effective | 2019-01-01 |
Who bills A9589 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 28 |
| Medicare beneficiaries | 130 |
| States with claims | 4 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A9589, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 676 | 484 | $1,200.20 | $956.94 |
| 2023 | 455 | 343 | $1,212.75 | $964.31 |
| 2024 | 175 | 130 | $1,315.70 | $1,043.13 |
States with the most A9589 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Texas | 66 | $1,042.43 |
| Ohio | 25 | $1,027.07 |
| Tennessee | 19 | $1,035.25 |
| California | 16 | $1,068.76 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 1 | Prescribing Information |
| practitioner claims | 1 | Prescribing Information |
What changed for A9589
- 2019-01-01: A9589 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 A9589?
A9589 is the HCPCS Level II code for instillation, hexaminolevulinate hydrochloride, 100 mg. Short descriptor: "Insti hexaminolevulinate hcl".
How much does Medicare pay for A9589?
In 2024, the average Medicare payment was $1,043.13 per service (average allowed $1,315.70).
Does Medicare cover A9589?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of A9589 can be billed per day?
1 on outpatient hospital claims; 1 on practitioner claims (NCCI medically unlikely edits).
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Next steps
- Run a reimbursement report for a device billed under A9589
- Watch A9589 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A9589
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.