| Code | Description | States | Median rate |
|---|---|---|---|
| A7000 | Canister, disposable, used with suction pump, each | 44 | $8.47 |
| A7001 | Canister, non-disposable, used with suction pump, each | 35 | $37.70 |
| A7002 | Tubing, used with suction pump, each | 42 | $4.02 |
| A7003 | Administration set, with small volume nonfiltered pneumatic nebulizer, disposable | 39 | $2.18 |
| A7004 | Small volume nonfiltered pneumatic nebulizer, disposable | 36 | $1.58 |
| A7005 | Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable | 42 | $20.42 |
| A7006 | Administration set, with small volume filtered pneumatic nebulizer | 36 | $9.19 |
| A7007 | Large volume nebulizer, disposable, unfilled, used with aerosol compressor | 37 | $3.68 |
| A7008 | Large volume nebulizer, disposable, prefilled, used with aerosol compressor | 29 | $12.54 |
| A7009 | Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer | 28 | $50.95 |
| A7010 | Corrugated tubing, disposable, used with large volume nebulizer, 100 feet | 38 | $20.66 |
| A7012 | Water collection device, used with large volume nebulizer | 37 | $3.40 |
| A7013 | Filter, disposable, used with aerosol compressor or ultrasonic generator | 38 | $0.72 |
| A7014 | Filter, nondisposable, used with aerosol compressor or ultrasonic generator | 35 | $4.32 |
| A7015 | Aerosol mask, used with dme nebulizer | 41 | $1.60 |
| A7016 | Dome and mouthpiece, used with small volume ultrasonic nebulizer | 32 | $8.79 |
| A7017 | Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen | 29 | $128.06 |
| A7018 | Water, distilled, used with large volume nebulizer, 1000 ml | 32 | $0.39 |
| A7020 | Interface for cough stimulating device, includes all components, replacement only | 31 | $17.01 |
| A7021 | Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter) | 15 | $117.15 |
| A7025 | High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each | 34 | $400.00 |
| A7026 | High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each | 32 | $32.77 |
| A7027 | Combination oral/nasal mask, used with continuous positive airway pressure device, each | 36 | $161.94 |
| A7028 | Oral cushion for combination oral/nasal mask, replacement only, each | 36 | $41.89 |
| A7029 | Nasal pillows for combination oral/nasal mask, replacement only, pair | 34 | $19.26 |
| A7030 | Full face mask used with positive airway pressure device, each | 42 | $133.28 |
| A7031 | Face mask interface, replacement for full face mask, each | 42 | $52.13 |
| A7032 | Cushion for use on nasal mask interface, replacement only, each | 43 | $26.17 |
| A7033 | Pillow for use on nasal cannula type interface, replacement only, pair | 42 | $22.73 |
| A7034 | Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap | 43 | $84.17 |
| A7035 | Headgear used with positive airway pressure device | 42 | $28.74 |
| A7036 | Chinstrap used with positive airway pressure device | 43 | $13.68 |
| A7037 | Tubing used with positive airway pressure device | 42 | $24.83 |
| A7038 | Filter, disposable, used with positive airway pressure device | 43 | $3.34 |
| A7039 | Filter, non disposable, used with positive airway pressure device | 41 | $10.10 |
| A7040 | One way chest drain valve | 19 | $47.80 |
| A7041 | Water seal drainage container and tubing for use with implanted chest tube | 17 | $91.35 |
| A7044 | Oral interface used with positive airway pressure device, each | 34 | $106.68 |
| A7045 | Exhalation port with or without swivel used with accessories for positive airway devices, replacement only | 32 | $16.07 |
| A7046 | Water chamber for humidifier, used with positive airway pressure device, replacement, each | 44 | $16.41 |
| A7047 | Oral interface used with respiratory suction pump, each | 24 | $137.85 |
| A7048 | Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each | 29 | $48.02 |
| A7501 | Tracheostoma valve, including diaphragm, each | 33 | $121.80 |
| A7502 | Replacement diaphragm/faceplate for tracheostoma valve, each | 31 | $59.64 |
| A7503 | Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each | 31 | $13.55 |
| A7504 | Filter for use in a tracheostoma heat and moisture exchange system, each | 29 | $0.82 |
| A7505 | Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each | 30 | $5.64 |
| A7506 | Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each | 29 | $0.39 |
| A7507 | Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each | 40 | $2.85 |
| A7508 | Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each | 37 | $3.26 |
| A7509 | Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each | 33 | $1.71 |
| A7520 | Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each | 38 | $55.98 |
| A7521 | Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each | 40 | $56.09 |
| A7522 | Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each | 37 | $53.95 |
| A7523 | Tracheostomy shower protector, each | 14 | $9.47 |
| A7524 | Tracheostoma stent/stud/button, each | 32 | $87.39 |
| A7525 | Tracheostomy mask, each | 43 | $2.35 |
| A7526 | Tracheostomy tube collar/holder, each | 44 | $3.86 |
| A7527 | Tracheostomy/laryngectomy tube plug/stop, each | 35 | $4.08 |
Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Descriptions are ProviderSignal's own plain-language labels or public-domain CMS text.