Prior Authorization
Medicare Prior Authorization for CPT A7013
Disposable compressor filter · Standard commercial plans
Source
Data pending source-document linkage. Verify against Medicare's current clinical policy before submission.
Not medical advice. PA policies change frequently. Always confirm against the payer's current policy before submitting. d3rx pulls directly from publicly published policy PDFs and refreshes daily.
We don't have a source-backed prior-authorization verdict for CPT A7013 with Medicare under Standard commercial plans yet — confirm directly with the payer. The 2026 Medicare reference rate for this code is below, and you can draft the request free in Ask D3.
2026 Medicare rate for CPT A7013
CPT A7013 is not priced under the 2026 Medicare Physician Fee Schedule (status X) — drugs/biologicals price under ASP and lab tests under the CLFS. See the CPT A7013 code page for pricing detail.
How to submit the PA
- 1Verify the requirement against the current clinical policy linked above.
- 2Gather patient history, prior conservative treatment, and clinical justification.
- 3Submit via the payer's provider portal or designated PA channel.
- 4Document the reference number and follow up within 5 business days if no determination is received.
FAQ
- Does Medicare require prior authorization for CPT A7013?
- Status not confirmed in our dataset. Confirm against the current Medicare clinical policy before submitting.
- What documentation does Medicare require for CPT A7013?
- Documentation requirements vary by case. Standard items include clinical notes, imaging or test results, history of conservative treatment, and a clear statement of medical necessity.
- What if Medicare denies the PA for CPT A7013?
- Appeal in writing within 60 days, citing the specific clinical policy criteria the case meets and attaching supporting documentation. Many denials are reversed on first-level appeal when the criteria language is mirrored.
Other Medicare PA lookups
CPT A7013 prior authorization by payer
Draft the Medicare PA request for CPT A7013 — free
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