HCPCS A7037 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 A7037 by major payers:

$21.83

$19.34

$17.58

$17.20
| 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 A7037 | ||||||
United | A7037 | $11.46 | 1891187563 - AMBER WINSTON | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Speech-Language Pathologist (235Z00000X) |
United | A7037 | $11.46 | 1508228065 - KISHAN TARPARA | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Sleep Medicine (Internal Medicine) Physician (207RS0012X) |
United | A7037 | $11.46 | 1083706402 - SEAN DONAHUE | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Ophthalmology Physician (207W00000X) |
United | A7037 | $11.46 | 1396256921 - NICHOLAS THOMASON | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Acute Care Nurse Practitioner (363LA2100X) |
United | A7037 | $11.46 | 1497714794 - BARBARA GRIMM | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Family Nurse Practitioner (363LF0000X) |
United | A7037 | $11.46 | 1962962514 - RACHEL QUINN | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Pediatrics Physician (208000000X) |
United | A7037 | $11.46 | 1760841423 - ANANT SHUKLA | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Sports Medicine (Internal Medicine) Physician (207RS0010X) |
United | A7037 | $11.46 | 1114961513 - STEVEN HUMPHREY | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Cardiovascular Disease Physician (207RC0000X) |
United | A7037 | $11.46 | 1912432360 - CAITLIN CUTLER | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | DC | Pediatric Gastroenterology Physician (2080P0206X) |
United | A7037 | $11.46 | 1669719258 - JOSHUA SMITH | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Trauma Surgery Physician (2086S0127X) |
United | A7037 | $11.46 | 1154775666 - ALEKSANDRA MIUCIN | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | NC | Diagnostic Radiology Physician (2085R0202X) |
United | A7037 | $11.46 | 1477575876 - KENNETH FLETCHER | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Otolaryngology Physician (207Y00000X) |
United | A7037 | $11.46 | 1609239524 - MATTHEW HILLER | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | A7037 | $11.46 | 1417682311 - LESLIE STARK | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Physician Assistant (363A00000X) |
United | A7037 | $11.46 | 1386799583 - AMANDA YUNKER | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Gynecology Physician (207VG0400X) |
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 A7037 vs. Other Breathing Aids Codes
The HCPCS A7037 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 A7037 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 |
|---|---|---|
| A7036-HCPCS | Low | Chinstrap used with positive airway pressure device |
| A7037-HCPCS | Low | Tubing used with positive airway pressure device |
| A7038-HCPCS | Low | Filter, disposable, 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 A7037. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A7037 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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