Key facts for P9022
- Medicare payment
- $368.58
- OPPS rate, SI R
- Coverage code
- D
- special coverage instructions apply
- Facility outpatient MUE
- 12
- MAI 3
- NCCI PTP pairs
- 11
- 11 hospital outpatient
- LCDs and articles
- 0 / 0
TL;DR
CMS describes HCPCS P9022, added in 1987, as "Red blood cells, washed, each unit". Hospital outpatient departments are paid $368.58 for P9022 under status indicator R, APC 9518, minimum unadjusted copayment $73.72 (October 2026 Addendum B). Its 2026 Q4 MUEs per date of service: practitioner 2 (MAI 3, Clinical: CMS Workgroup); hospital outpatient 12 (MAI 3, Clinical: Data). In the NCCI PTP files v323r0 P9022 appears in 7 practitioner pairs as column 2 and 4 as column 1 (most often with P9011, P9032, P9033), and in 7 hospital outpatient pairs as column 2 and 4 as column 1. P9022 appears in no active LCD or billing and coding article, so coverage follows HCPCS coverage code D (special coverage instructions apply) and any NCD. HCPCS record: BETOS T1H (lab tests - other (non-Medicare fee schedule)); pricing indicator 52; type of service 0 (whole blood). 8 other active codes open with "Red blood cells"; related codes: P9021, P9016, P9040, P9027.
P9022 descriptor and code status
The October 2026 HCPCS Level II file describes P9022 as “Red blood cells, washed, each unit”. It sits in the P section (pathology and laboratory services), listed with the other P codes.
| Field | Value |
|---|---|
| Short descriptor | Washed red blood cells unit |
| Added to HCPCS | 1987-01-01 |
| Last action | N (no maintenance), effective 1987-01-01 |
| Coverage code | D: special coverage instructions apply |
| Pricing indicator | 52: reasonable charge |
| BETOS category | T1H: lab tests - other (non-Medicare fee schedule) |
| Type of service | 0: whole blood |
Medicare payment for P9022
Hospital outpatient departments are paid $368.58 for P9022 under status indicator R, APC 9518, minimum unadjusted copayment $73.72 (October 2026 Addendum B). 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 E: excluded from the physician fee schedule by regulation. Global period XXX (global surgery concept does not apply); PC/TC indicator 9 (professional/technical concept does not apply).
Hospital outpatient (OPPS Addendum B)
Status indicator R (Blood and blood products), APC 9518, national unadjusted payment $368.58 with a minimum unadjusted copayment of $73.72.
Medically Unlikely Edits for P9022
Its 2026 Q4 MUEs per date of service: practitioner 2 (MAI 3, Clinical: CMS Workgroup); hospital outpatient 12 (MAI 3, Clinical: Data). The facility outpatient MUE is a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation.
| Setting | MUE (units/DOS) | MAI | CMS rationale |
|---|---|---|---|
| Practitioner services | 2 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
| Facility outpatient hospital | 12 | 3 Date of Service Edit: Clinical | Clinical: Data |
The MUE lookup for P9022 shows every setting next to any other code on the same claim.
NCCI edits and add-on rules
In the practitioner PTP file v323r0, P9022 is the column-2 (bundled) code in 7 active pairs, 86% of which allow a modifier and the column-1 code in 4 (100% modifier-allowed); 0 earlier pairs have been deleted. CMS's most frequent rationale for the bundled pairs: Misuse of Column Two code with Column One code.
In the hospital outpatient PTP file v323r0, P9022 is the column-2 (bundled) code in 7 active pairs, 86% of which allow a modifier and the column-1 code in 4 (100% modifier-allowed); 0 earlier pairs have been deleted. CMS's most frequent rationale for the bundled pairs: Misuse of Column Two code with Column One code.
P9022 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 P9022 against a second code to see whether the pair bundles and whether a modifier can separate the services.
Medicare coverage policies for P9022
No current LCD or billing and coding article lists P9022. The HCPCS coverage code D means special coverage instructions apply, and any National Coverage Determination for the service still applies.
Denials to expect on P9022
the modifier reported is inconsistent with the code
the claim lacks information needed to adjudicate the line, such as an order, NPI or required modifier
Where QuickIntell fits for P9022 claims
QuickCode supports qualified coder review of units, modifiers and NCCI pairs for P9022 before the claim leaves, and QuickRCM carries claim readiness and the denial follow-up when an edit or coverage policy is missed.
Frequently asked questions: HCPCS P9022
What does HCPCS code P9022 describe?
"Red blood cells, washed, each unit" (short descriptor "Washed red blood cells unit"), in the P section (pathology and laboratory services). Added 1987-01-01.
Is P9022 a CPT code?
No. P9022 is a CMS HCPCS Level II code; CPT codes are the AMA's five-character set.
What does Medicare pay for P9022?
Hospital outpatient departments are paid $368.58 for P9022 under status indicator R, APC 9518, minimum unadjusted copayment $73.72 (October 2026 Addendum B).
How many units of P9022 can be billed per day?
Its 2026 Q4 MUEs per date of service: practitioner 2 (MAI 3, Clinical: CMS Workgroup); hospital outpatient 12 (MAI 3, Clinical: Data). For the facility outpatient MUE (MAI 3), units above 12 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.
Does Medicare cover P9022?
P9022 appears in no active LCD or billing and coding article, so coverage follows HCPCS coverage code D (special coverage instructions apply) and any NCD.
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.
- HCPCS Level II alpha-numeric file, October 2026Version October 2026 · effective 2026-10-01 · file HCPC2026_OCT_ANWEB_09232026.txtSHA-256 c25240c63108756d…
- Medicare PFS national relative value file RVU26D (non-QPP), October 2026Version RVU26D, released 2026-08-26 · effective 2026-10-01 · file PPRRVU2026_Oct_nonQPP.csvSHA-256 4d0d3f19bd954ffc…
- Medicare PFS national relative value file RVU26D (qualifying APM participants), October 2026Version RVU26D, released 2026-08-26 · effective 2026-10-01 · file PPRRVU2026_Oct_QPP.csvSHA-256 59d3734704853936…
- OPPS Addendum B, October 2026Version October 2026 · effective 2026-10-01 · file 508-compliant-version-2026_October_Web_Addendum_B.09.28.26.csvSHA-256 6ad7393a318bf1b9…
- Integrated Outpatient Code Editor v27.3 data tables: status and payment indicatorsVersion I/OCE v27.3 (October 2026) · effective 2026-10-01 · file Data_Status_Indicator.txtSHA-256 78f119ef0a435351…
- NCCI MUE table, practitioner services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_PractitionerServices_Eff_10-01-2026.csvSHA-256 ef038efaf902b7bd…
- NCCI MUE table, facility services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_OutpatientHospitalServices_Eff_10-01-2026.csvSHA-256 3af9f4e99cc587e2…
- NCCI MUE table, dme services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_DMESupplierServices_Eff_10-01-2026.csvSHA-256 6fa4fbba852f7b74…
- NCCI PTP edits, practitioner, v323r0 (four files)Version v323r0 (2026 Q4) · effective 2026-10-01 · file ccipra-v323r0-f1.TXTSHA-256 7793c0b6686c1e22…
- NCCI PTP edits, hospital outpatient, v323r0 (four files)Version v323r0 (2026 Q4) · effective 2026-10-01 · file ccioph-v323r0-f1.txtSHA-256 063f41b91ef9faa2…
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.