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HCPCS A9601 · Level II · Part B drug

A9601: flortaucipir f 18 injection (Tauvid), HCPCS Level II drug code

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: OPPS Addendum B: October 2026 (effective October 1, 2026); OPPS NDC-HCPCS crosswalk: October 2026 (effective October 1, 2026); NCCI MUE tables: 2026 Q4 (effective October 1, 2026); NCCI PTP edits: v323r0 (2026 Q4) (effective October 1, 2026); ASC Addendum BB (covered ancillary services): October 2026 (effective October 1, 2026). Next CMS release: January 1, 2027 (quarterly update).

Key facts for A9601

Billing unit
1 mCi
Flortaucipir inj 1 millicuri
OPPS payment rate
$371.00
no ASP limit; SI G, October 2026
Practitioner MUE
10
MAI 3
OPPS status
SI G
APC 0709
NCCI exposure
no PTP pairs
Coverage articles
3
10 states

TL;DR

HCPCS A9601 is the Level II code for Flortaucipir f 18 injection, diagnostic, 1 millicurie, billed per 1 mCi. CMS publishes no ASP payment limit for it; hospital outpatient departments are paid separately under OPPS (status indicator G, $371.00 per billing unit in October 2026). The practitioner MUE allows up to 10 units per date of service (MAI 3). Unlike most diagnostic agents, which OPPS packages into the procedure (status N), A9601 is paid separately in the hospital outpatient department (status G). The OPPS crosswalk maps 1 NDC to it, sold as Tauvid by Eli Lilly and Company. 3 Medicare coverage articles list the code across 7 states plus DC and 2 territories, including A53134.

Medicare payment: OPPS rate (no ASP limit)

A9601 does not appear in the October 2026 Part B ASP payment limit file. CMS pays it separately to hospital outpatient departments under OPPS with status indicator G in APC 0709, at a national unadjusted rate of $371.00 per 1 mCi. Status G is drug pass-through payment, which lasts a limited number of years. In a physician office the Medicare contractor prices the drug, often from invoice; commercial and Medicaid payers set their own rates.

NDC to HCPCS billing-unit conversion

The October 2026 OPPS crosswalk maps 1 NDC from 1 labeler to A9601. Report the NDC in the claim's drug segment and bill the number of A9601 units that equals the quantity administered divided by 1 mCi; the last column gives units per full package.

NDCs that crosswalk to A9601
NDCDrug nameLabelerPackage sizeBilling units / package
00002-1220-01TauvidEli Lilly and Company1 × 11

Medically Unlikely Edits (MUE)

CMS publishes 2 MUE values for A9601. For practitioners the limit is 10 units per date of service with adjudication indicator 3, a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation that the quantity was medically reasonable.

MUE values for A9601 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services103 Date of Service Edit: ClinicalPrescribing Information
Facility outpatient hospital103 Date of Service Edit: ClinicalPrescribing Information

MUE for A9601 in every setting opens the lookup with this code filled in, next to any other code on the same claim.

NCCI edits and add-on relationships

No active practitioner PTP pair lists A9601 as a column-1 or column-2 code in v323r0. Drug supply codes are rarely bundled; the administration codes billed with them are where PTP edits usually apply.

The counts above are exposure, not answers for a specific claim. Check A9601 against another code to see whether a given pair bundles, which code is paid and whether a modifier can separate them.

A9601 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Medicare coverage articles

3 current Medicare Administrative Contractor articles list A9601 in their HCPCS tables, covering 10 states. Each article carries the covered and non-covered ICD-10 codes that medical-necessity denials (CARC 50) are adjudicated against.

Billing and Coding Articles listing A9601
ArticleTitleContractor(s)StatesRelated LCD
A53134Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic ConditionsNovitas Solutions, Inc.DC DE MD NJ PA—
A59049Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic ConditionsFirst Coast Service Options, Inc.FL PR VI—
A59318Billing and Coding: Positron Emission Tomography (PET) Scan for Inflammation and InfectionCGS Administrators, LLCKY OHL39521

Local coverage policies that list A9601

1 active Local Coverage Determination lists A9601 in the policy or in its billing and coding article. Each applies only in its contractor's jurisdiction; check the one for the state where the drug is administered.

Hospital outpatient (OPPS) status

In the October 2026 OPPS Addendum B, A9601 carries status indicator G and is assigned to APC 0709, with a published national unadjusted payment of $371.00. Status G marks pass-through drug payment, which is time-limited.

Ambulatory surgical center (ASC) payment

In the October 2026 ASC Addendum BB (covered ancillary services), A9601 carries payment indicator K2, which CMS defines as "Drugs, biologicals, and radiopharmaceuticals paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS rate". The national ASC payment is $371.00 per 1 mCi, paid only when the drug is furnished integral to a covered surgical procedure. Pass-through status expires *.

Common denials for A9601 and how to prevent them

CARC 16 · M119

NDC missing, invalid or not matched to the HCPCS code

CARC 151 · N362

units billed exceed the MUE for the date of service

CARC 50 · N115

diagnosis not covered by the applicable coverage article or LCD

How QuickIntell checks A9601 before the claim leaves

QuickCode validates the NDC-to-unit conversion against the current OPPS NDC-HCPCS crosswalk, checks units against every published MUE setting and flags PTP and add-on conflicts on the same claim. QuickRCM routes CARC 16, 151 and 50 denials on drug lines with the matching coverage article attached so the appeal starts with evidence.

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Frequently asked questions — HCPCS A9601

What does HCPCS code A9601 describe?

A9601 is defined by CMS as "Flortaucipir f 18 injection, diagnostic, 1 millicurie". Each billing unit represents 1 mCi, so the units reported on the claim must equal the dose administered divided by that unit.

Is A9601 a CPT code?

No. A9601 is a HCPCS Level II code, the letter-plus-four-digit set CMS maintains for drugs such as flortaucipir f 18 injection (Tauvid); CPT codes are five-character codes maintained by the AMA. On a Part B claim A9601 reports the drug itself in 1 mci units, and the administration is billed on its own line.

What does Medicare pay for A9601 in a hospital outpatient department?

A9601 has no Part B ASP limit; the October 2026 OPPS Addendum B pays it separately under status G, APC 0709, at $371.00 per 1 mCi, and ASC Addendum BB gives it payment indicator K2 at $371.00.

How many units of A9601 can be billed per day?

The practitioner Medically Unlikely Edit is 10 units per date of service with adjudication indicator 3 (Date of Service Edit: Clinical). MAI 3 edits can be appealed with documentation that the units were medically reasonable. CMS cites "Prescribing Information" as the rationale.

Which NDCs map to A9601?

The October 2026 OPPS crosswalk lists 1 NDC from 1 labeler: Tauvid (Eli Lilly and Company). For example NDC 00002-1220-01 (package size 1) equals 1 billing unit of A9601.

Does A9601 have NCCI bundling edits?

No active practitioner PTP pairs list A9601 as a column-1 or column-2 code in the v323r0 release.

Which Medicare coverage articles mention A9601?

3 current Billing and Coding Articles in the Medicare Coverage Database list A9601, covering 7 states plus DC and 2 territories: A53134 (Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions); A59049 (Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions); A59318 (Billing and Coding: Positron Emission Tomography (PET) Scan for Inflammation and Infection).

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

This page is an operational reference compiled from CMS publications: the Medicare Part B drug payment limit and NDC crosswalk files, NCCI MUE and add-on edit tables, aggregate PTP statistics, OPPS Addendum B, ASC Addendum BB and the Medicare Coverage Database. Payment limits and rates are Medicare national amounts; commercial and Medicaid payers differ. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.