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HCPCS A9699 · Level II · A code

A9699: Radiopharmaceutical, therapeutic, not otherwise classified, HCPCS Level II A code

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

Data currency: HCPCS Level II file: October 2026 (effective October 1, 2026); PFS relative value file: RVU26D, released August 26, 2026 (effective October 1, 2026); NCCI MUE tables: 2026 Q4 (effective October 1, 2026); NCCI PTP edits: v323r0 (2026 Q4) (effective October 1, 2026); OPPS Addendum B: October 2026 (effective October 1, 2026); Medicare Coverage Database LCD export: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: January 1, 2027 (quarterly update) for the HCPCS Level II file and NCCI MUE tables and NCCI PTP edits and OPPS Addendum B; RVU27A with the CY2027 PFS final rule, effective January 1, 2027 for the PFS relative value file; weekly, every Thursday for the Medicare Coverage Database LCD export.

Key facts for A9699

Medicare payment
no PFS amount
PFS status C
Coverage code
C
carrier judgment, so the Medicare contractor decides coverage
MUE
none published
no MUE in the 2026 Q4 tables
OPPS status
SI N
Items and Services packaged into APC rates
NCCI PTP pairs
0
0 hospital outpatient
LCDs and articles
0 / 1

TL;DR

CMS describes HCPCS A9699, added in 2003, as "Radiopharmaceutical, therapeutic, not otherwise classified". The physician fee schedule lists A9699 with status C (contractor-priced: the MAC sets RVUs and payment case by case), so the PFS carries no national amount for it. 1 billing and coding article lists A9699 across 4 states: A54880. OPPS status indicator N: Items and Services packaged into APC rates. HCPCS record: BETOS I1E (standard imaging - nuclear medicine); pricing indicator 57; type of service 6 (therapeutic radiology). 1 other active code opens with "Radiopharmaceutical"; related codes: A4641, A9597, A9562, A9561.

A9699 descriptor and code status

The October 2026 HCPCS Level II file describes A9699 as “Radiopharmaceutical, therapeutic, not otherwise classified”. It sits in the A section (transportation, medical and surgical supplies, administrative, miscellaneous and investigational), listed with the other A codes.

HCPCS file attributes of A9699
FieldValue
Short descriptorRadiopharm rx agent noc
Added to HCPCS2003-01-01
Last actionN (no maintenance), effective 2006-01-01
Coverage codeC: carrier judgment, so the Medicare contractor decides coverage
Pricing indicator57: other contractor-priced
BETOS categoryI1E: standard imaging - nuclear medicine
Type of service6: therapeutic radiology

Medicare payment for A9699

The physician fee schedule lists A9699 with status C (contractor-priced: the MAC sets RVUs and payment case by case), so the PFS carries no national amount for it. The amounts below are national figures from the October 2026 CMS files; the contractor applies the locality, rural or state adjustment and the beneficiary's cost sharing.

Physician fee schedule (RVU26D)

Status C: contractor-priced: the MAC sets RVUs and payment case by case. Global period XXX (global surgery concept does not apply); PC/TC indicator 0 (physician service; the professional/technical split does not apply).

Hospital outpatient (OPPS Addendum B)

Status indicator N (Items and Services packaged into APC rates), with no separate OPPS payment rate.

Medically Unlikely Edits for A9699

CMS publishes no MUE for A9699 in the 2026 Q4 practitioner, facility or DME supplier tables. Some MUE values are confidential and applied without publication, so unit limits can still deny; document the quantity furnished on every claim.

The MUE lookup for A9699 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

No active practitioner PTP pair lists A9699 in v323r0.

A9699 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Pair counts show exposure, not the answer for one claim. Check A9699 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for A9699

0 active Local Coverage Determinations and 1 billing and coding article list A9699. Each applies only in its contractor's jurisdiction, and the article carries the diagnosis codes that support the item or service.

Billing and Coding Articles listing A9699
ArticleTitleContractor(s)Related LCD
A54880Billing and Coding: Additional Claim Documentation Requirements for Not Otherwise Classified (NOC) Drugs and Biological Products with Specific FDA Label IndicationsPalmetto GBA—

Denials to expect on A9699

CARC 50 · N115

the diagnosis or documentation does not meet the LCD or billing article that lists A9699

CARC 151 · N362

units exceed what the payer considers medically likely for one date of service

CARC 4

the modifier reported is inconsistent with the code

CARC 16

the claim lacks the description, invoice or pricing detail a contractor-priced code needs

Where QuickIntell fits for A9699 claims

QuickCode supports qualified coder review of units, modifiers and NCCI pairs for A9699 before the claim leaves, and QuickRCM carries claim readiness and the denial follow-up when an edit or coverage policy is missed.

See QuickCode for coder reviewSee QuickRCM for denial follow-upBook a meeting

Frequently asked questions: HCPCS A9699

What does HCPCS code A9699 describe?

"Radiopharmaceutical, therapeutic, not otherwise classified" (short descriptor "Radiopharm rx agent noc"), in the A section (transportation, medical and surgical supplies, administrative, miscellaneous and investigational). Added 2003-01-01; last action N (no maintenance) effective 2006-01-01.

Is A9699 a CPT code?

No. A9699 is a CMS HCPCS Level II code; CPT codes are the AMA's five-character set.

What does Medicare pay for A9699?

The physician fee schedule lists A9699 with status C (contractor-priced: the MAC sets RVUs and payment case by case), so the PFS carries no national amount for it.

Does Medicare cover A9699?

Coverage code C (carrier judgment, so the Medicare contractor decides coverage). 1 billing and coding article lists A9699 across 4 states: A54880.

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 HCPCS Level II file, the physician, DMEPOS and clinical laboratory fee schedules, OPPS and ASC addenda, NCCI MUE, PTP and add-on edit tables and the Medicare Coverage Database. Amounts are Medicare national figures before locality and state adjustment; Medicaid and commercial payers set their own. 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.