HCPCS A7036 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Medical And Surgical Supplies • Breathing Aids |
| Complexity Level | Low |
National average reimbursement for HCPCS A7036 by major payers:

$11.72

$9.71

$10.80

$15.09
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS A7036 | ||||||
United | A7036 | $7.17 | 1316289101 - SHIAYIN YANG | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | IL | Facial Plastic Surgery Physician (207YS0123X) |
United | A7036 | $7.17 | 1598083826 - ASHLEY TAURIAC | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | VA | Pediatrics Physician (208000000X) |
United | A7036 | $7.17 | 1821185935 - NEERAJA PETERSON | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Internal Medicine Physician (207R00000X) |
United | A7036 | $7.17 | 1912391509 - ANDREA MANA | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Advanced Practice Midwife (367A00000X) |
United | A7036 | $7.17 | 1427415090 - KAYLA HINES | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Physician Assistant (363A00000X) |
United | A7036 | $7.17 | 1366845000 - RENATE MEIER | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Women's Health Nurse Practitioner (363LW0102X) |
United | A7036 | $7.17 | 1477595106 - TRACEY GODDARD | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Acute Care Nurse Practitioner (363LA2100X) |
United | A7036 | $7.17 | 1891882916 - KAREN MCCARTY | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Family Nurse Practitioner (363LF0000X) |
United | A7036 | $7.17 | 1497884647 - MATTHEWS CHACKO | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | MD | Interventional Cardiology Physician (207RI0011X) |
United | A7036 | $7.17 | 1669695250 - MARYLOU SMITH | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Advanced Practice Midwife (367A00000X) |
United | A7036 | $7.17 | 1356853279 - MADALENE DRUMMOND | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Family Nurse Practitioner (363LF0000X) |
United | A7036 | $7.17 | 1992117097 - BRIANNA SMITH | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Pediatric Hematology & Oncology Physician (2080P0207X) |
United | A7036 | $7.17 | 1609118058 - MILNER STAUB | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Infectious Disease Physician (207RI0200X) |
United | A7036 | $7.17 | 1528487550 - DEREK KRUSE | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Hospitalist Physician (208M00000X) |
United | A7036 | $7.17 | 1316380082 - DAVID PATRICK | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Cardiovascular Disease Physician (207RC0000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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HCPCS A7036 vs. Other Breathing Aids Codes
The HCPCS A7036 code is part of the Medical And Surgical Supplies services used for Breathing Aids. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS A7036 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| A7035-HCPCS | Low | Headgear used with positive airway pressure device |
| A7036-HCPCS | Low | Chinstrap used with positive airway pressure device |
| A7037-HCPCS | Low | Tubing used with positive airway pressure device |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A7036. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A7036 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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