2024 Medicare Coding and Payment Rates for PICO sNPWT
Effective January 1, 2024, you may now bill for Single Use Negative Pressure Wound Therapy (sNPWT) using HCPCS code A9272 on Type of Bill (TOB) 32X for the device only.
HCPCS® Code: A9272
Description: Wound suction, disposable, includes dressing, all accessories and components, any type, each.
Status indicator: A
Total Medicare allowable*: $270.09
Home health agencies receive a separate payment for negative pressure wound therapy (NPWT) using a disposable device, such as PICO Single Use Negative Pressure Wound Therapy, for Medicare beneficiaries who receive home health agency services under a home health plan of care. These services may be performed by registered nurses, licensed practical nurses, physical therapists, or occupational therapists that are permitted to perform wound assessments under state law.
Note: Claims for sNPWT sent on TOB 34X with CPT codes 97607 or 97608 and claim on or after January 1, 2024 will be returned to the provider. In addition, nursing and therapy services related to the application of the device will be reported on TOB 32X and are no longer separately billable, as they are included in the home health bundled payment. For more information, please refer to the Oct 5, 2023 CMS MLN Matters (MM13244) on Separate Payment for Disposable Negative Pressure Wound Therapy Devices on Home Health Claims. The document is available at https://www.cms.gov/files/document/mm13244-separate-payment-disposable-negative-pressure-wound-therapy-devices-home-health-claims.pdf
