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See a sample rate comparisonHCPCS A7036 Fee Schedule
Last Verified: September 2026
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.
Chinstrap used with positive airway pressure device
| Key Fact | Detail |
|---|---|
| Service Type | Medical And Surgical Supplies Breathing Aids |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for A7036 |
National average reimbursement for HCPCS A7036 by major payers:
$11.72
$9.71
$10.80
$15.09
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HCPCS A7036
5 of 25 sample ratesHigher to lower in this preview
Shiayin Yang
Vanderbilt University Medical Center
$7.17Published rateTracey Goddard
Vanderbilt University Medical Center
$7.17Published rateMilner Staub
Vanderbilt University Medical Center
$7.17Published rateNorma Edwards
Vanderbilt University Medical Center
$7.17Published rateBriana Mcvean
Vanderbilt University Medical Center
$7.17Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS 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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