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HCPCS A9606 · Level II · Part B drug

HCPCS A9606: Radium ra-223 dichloride, therapeutic, per microcurie

Reviewed by QuickIntell RCM Editorial Team · Last reviewed

Data effective
Data currency: ASP payment limits October 2026 (effective October 1, 2026); MUE and NCCI edits 2026 Q4 (effective October 1, 2026); OPPS Addendum B July 2026 (effective July 1, 2026). Next CMS release: January 1, 2027 (ASP, MUE, NCCI and OPPS quarterly updates).

Key facts for A9606

Billing unit
1 microCurie
Radium ra223 dichloride ther
ASP payment limit
n/a
October 2026
Practitioner MUE
224
MAI 3
OPPS status
SI K
APC 1745
NCCI exposure
no PTP pairs
Coverage articles
1
7 states

TL;DR

HCPCS A9606 is the Level II code for Radium ra-223 dichloride, therapeutic, per microcurie, billed per 1 microCurie. The practitioner MUE allows up to 224 units per date of service (MAI 3). Under OPPS it carries status indicator K in APC 1745. A9606 is billed in units of 1 microCurie; the quantity administered, the NDC package and the units on the claim must reconcile, which is the check that prevents CARC 16 and 151 returns on this line. 1 Medicare coverage article lists the code across 7 states, including .

Medicare Part B payment limit (ASP)

CMS sets the Part B payment limit for A9606 at n/a per 1 microCurie for October 2026, derived from manufacturer average sales price plus 6%. Beneficiary coinsurance is 20%.

ASP payment limits for A9606
QuarterPayment limitPerCoinsurance
October 2026n/a1 microCurie20%
July 2026n/a1 microCurie—
CMS note: microCurie 100% AWP = $212.84 microCurie 100% WAC = $177.37

NDC to HCPCS billing-unit conversion

The October 2026 ASP crosswalk lists no NDC for A9606. Report the NDC from the product label and confirm the units conversion from the HCPCS descriptor (Radium ra-223 dichloride, therapeutic, per microcurie).

Medically Unlikely Edits (MUE)

CMS publishes 2 MUE values for A9606. For practitioners the limit is 224 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 A9606 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services2243 Date of Service Edit: ClinicalPrescribing Information
Facility outpatient hospital2243 Date of Service Edit: ClinicalPrescribing Information

NCCI edits and add-on relationships

No active practitioner PTP pair lists A9606 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.

A9606 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Medicare coverage articles

1 current Medicare Administrative Contractor article lists A9606 in their HCPCS tables, covering 7 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 A9606
ArticleTitleContractor(s)StatesRelated LCD
Billing and Coding: Xofigo Billing InstructionsPalmetto GBAAL GA NC SC TN VA WV—

Hospital outpatient (OPPS) status

In the July 2026 OPPS Addendum B, A9606 carries status indicator K and is assigned to APC 1745, with a published national unadjusted payment of $181.55. Status K means the drug is paid separately under OPPS at the ASP-based rate rather than packaged into the procedure.

Common denials for A9606 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 A9606 before the claim leaves

QuickCode validates the NDC-to-unit conversion against the current ASP 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.

Explore QuickCodeExplore QuickRCMBook a demo

Frequently asked questions — HCPCS A9606

What does HCPCS code A9606 describe?

A9606 is defined by CMS as "Radium ra-223 dichloride, therapeutic, per microcurie". Each billing unit represents 1 microCurie, so the units reported on the claim must equal the dose administered divided by that unit.

How many units of A9606 can be billed per day?

The practitioner Medically Unlikely Edit is 224 units per date of service with adjudication indicator 3 (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.

Does A9606 have NCCI bundling edits?

No active practitioner PTP pairs list A9606 as a column-1 or column-2 code in the v323r0 release. Unit limits (MUE) and medical-necessity coverage rules still apply.

Which Medicare coverage articles mention A9606?

1 current Billing and Coding Article in the Medicare Coverage Database list A9606, covering 7 states: (Billing and Coding: Xofigo Billing Instructions).

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-01. Verify against the primary file before billing or contracting decisions.

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 and the Medicare Coverage Database. Payment limits 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.