P9020 HCPCS code: Platelet rich plasma, each unit
P9020 is the HCPCS Level II code for platelet rich plasma, each unit. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 5 per day on outpatient hospital claims.
Code details
| Field | Value |
|---|---|
| Section | P codes — Pathology and laboratory services |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 52 |
| BETOS category | T1H |
| Added | 1987-01-01 |
| Last action effective | 2001-01-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 5 | Clinical: Data |
| practitioner claims | 2 | Clinical: Data |
Medicare policy articles for this code
- A58282: Billing and Coding: Platelet Rich Plasma (Palmetto GBA (MAC - Part A, MAC - Part B))
- A58609: Billing and Coding: Platelet Rich Plasma (Wellpoint Federal (MAC - Part A, MAC - Part B))
- A58737: Billing and Coding: Platelet Rich Plasma Injections for Non-Wound Injections (CGS Administrators, LLC (MAC - Part A, MAC - Part B))
- A58788: Billing and Coding: Platelet Rich Plasma Injections for Non-Wound Injections (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B))
- A58808: Billing and Coding: Platelet Rich Plasma (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B))
- A58810: Billing and Coding: Platelet Rich Plasma (First Coast Service Options, Inc. (MAC - Part A, MAC - Part B))
What changed for P9020
- 1987-01-01: P9020 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 P9020?
P9020 is the HCPCS Level II code for platelet rich plasma, each unit. Short descriptor: "Plaelet rich plasma unit".
Does Medicare cover P9020?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of P9020 can be billed per day?
5 on outpatient hospital claims; 2 on practitioner claims (NCCI medically unlikely edits).
Related P90 codes
- P9010 — Blood (whole), for transfusion, per unit
- P9011 — Blood, split unit
- P9012 — Cryoprecipitate, each unit
- P9016 — Red blood cells, leukocytes reduced, each unit
- P9017 — Fresh frozen plasma (single donor), frozen within 8 hours of collection, each unit
- P9019 — Platelets, each unit
- P9021 — Red blood cells, each unit
- P9022 — Red blood cells, washed, each unit
- P9023 — Plasma, pooled multiple donor, solvent/detergent treated, frozen, each unit
- P9025 — Plasma, cryoprecipitate reduced, pathogen reduced, each unit
- P9026 — Cryoprecipitated fibrinogen complex, pathogen reduced, each unit
- P9027 — Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit
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Next steps
- Run a reimbursement report for a device billed under P9020
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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.