A9595 HCPCS code: Piflufolastat f 18 (pylarify), diagnostic, 1 millicurie
A9595 is the HCPCS Level II code for piflufolastat f 18 (pylarify), diagnostic, 1 millicurie. In 2024 Medicare paid an average of $497.63 per service for A9595 across 279,292 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 rose 125% from 2022 to 2024 (124,237 to 279,292 services). In 2024, about 1,762 clinicians billed Medicare for A9595 for 29,625 beneficiaries; California, New York, Florida accounted for 36% of services.
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 | 2022-01-01 |
| Last action effective | 2026-10-01 |
Who bills A9595 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 1,762 |
| Medicare beneficiaries | 29,625 |
| States with claims | 45 |
| Share of services in top 3 states (California, New York, Florida) | 36% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A9595, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 124,237 | 16,325 | $767.23 | $612.08 |
| 2023 | 224,911 | 24,849 | $625.60 | $498.42 |
| 2024 | 279,292 | 29,625 | $624.70 | $497.63 |
States with the most A9595 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 44,516 | $504.96 |
| New York | 34,826 | $499.66 |
| Florida | 21,920 | $500.08 |
| Maryland | 19,606 | $452.67 |
| Texas | 18,344 | $468.12 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 10 | Prescribing Information |
| practitioner claims | 10 | Prescribing Information |
What changed for A9595
- October 2026: Descriptor revised (Was: Piflufolastat f-18, diagnostic, 1 millicurie)
- 2026-10-01: Last CMS action: long description changed
- 2022-01-01: A9595 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 A9595?
A9595 is the HCPCS Level II code for piflufolastat f 18 (pylarify), diagnostic, 1 millicurie. Short descriptor: "Piflu f 18 pylarify dx 1 mci".
How much does Medicare pay for A9595?
In 2024, the average Medicare payment was $497.63 per service (average allowed $624.70).
Does Medicare cover A9595?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of A9595 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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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 A9595
- Watch A9595 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A9595
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.