A9596 HCPCS code: Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie
A9596 is the HCPCS Level II code for gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie. In 2024 Medicare paid an average of $823.23 per service for A9596 across 60,078 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 7 per day on outpatient hospital claims. Medicare volume rose 370% from 2022 to 2024 (12,775 to 60,078 services). In 2024, about 801 clinicians billed Medicare for A9596 for 10,586 beneficiaries; Florida, California, Texas accounted for 40% 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 | 2022-07-01 |
| Last action effective | 2022-07-01 |
Who bills A9596 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 801 |
| Medicare beneficiaries | 10,586 |
| States with claims | 41 |
| Share of services in top 3 states (Florida, California, Texas) | 40% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A9596, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 12,775 | 2,634 | $1,080.72 | $861.19 |
| 2023 | 39,871 | 7,303 | $1,020.53 | $813.08 |
| 2024 | 60,078 | 10,586 | $1,033.33 | $823.23 |
States with the most A9596 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 10,513 | $847.47 |
| California | 7,185 | $850.45 |
| Texas | 6,139 | $769.46 |
| Tennessee | 3,111 | $826.53 |
| Virginia | 2,840 | $824.22 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 7 | Prescribing Information |
| practitioner claims | 7 | Prescribing Information |
What changed for A9596
- 2022-07-01: A9596 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 A9596?
A9596 is the HCPCS Level II code for gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie. Short descriptor: "Gallium illuccix 1 millicure".
How much does Medicare pay for A9596?
In 2024, the average Medicare payment was $823.23 per service (average allowed $1,033.33).
Does Medicare cover A9596?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of A9596 can be billed per day?
7 on outpatient hospital claims; 7 on practitioner claims (NCCI medically unlikely edits).
Related A95 codes
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Next steps
- Run a reimbursement report for a device billed under A9596
- Watch A9596 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A9596
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.