HCPCS A7046 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 A7046 by major payers:

$14.04

$11.51

$12.09

$19.79
| 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 A7046 | ||||||
United | A7046 | $9.02 | 1730451576 - SAMAN IBRAHIM | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | MO | Diagnostic Radiology Physician (2085R0202X) |
United | A7046 | $9.02 | 1619516184 - SAMANTHA ECONOMOS | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | CO | Pediatric Nurse Practitioner (363LP0200X) |
United | A7046 | $9.02 | 1154749794 - RACHEL SULLIVAN | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | WI | Pediatric Cardiology Physician (2080P0202X) |
United | A7046 | $9.02 | 1093470486 - MEREDITH LEDBETTER | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Critical Care Neonatal Nurse Practitioner (363LN0005X) |
United | A7046 | $9.02 | 1780812289 - BRENT SAVOIE | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Diagnostic Radiology Physician (2085R0202X) |
United | A7046 | $9.02 | 1770882367 - JESSICA MATHER | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Ophthalmology Physician (207W00000X) |
United | A7046 | $9.02 | 1609079003 - MATTHEW FUSCO | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Neurological Surgery Physician (207T00000X) |
United | A7046 | $9.02 | 1245649227 - LEAH DICKEY | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Family Nurse Practitioner (363LF0000X) |
United | A7046 | $9.02 | 1710216122 - LISA FLEMMONS | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Acute Care Nurse Practitioner (363LA2100X) |
United | A7046 | $9.02 | 1932471034 - MARY MCLAUGHLIN | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Family Nurse Practitioner (363LF0000X) |
United | A7046 | $9.02 | 1851703474 - CLAUSYL PLUMMER | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TX | Physical Medicine & Rehabilitation Physician (208100000X) |
United | A7046 | $9.02 | 1790983351 - MELISSA PICARD | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | SC | Diagnostic Radiology Physician (2085R0202X) |
United | A7046 | $9.02 | 1134562184 - TYLER REESE | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Internal Medicine Physician (207R00000X) |
United | A7046 | $9.02 | 1629397047 - LAVEIL ALLEN | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Diagnostic Radiology Physician (2085R0202X) |
United | A7046 | $9.02 | 1366896128 - MCKENZIE VATER | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Pediatrics Physician (208000000X) |
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 A7046 vs. Other Breathing Aids Codes
The HCPCS A7046 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 A7046 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 |
|---|---|---|
| A7045-HCPCS | Low | Exhalation port with or without swivel used with accessories for positive airway devices, replacement only |
| A7046-HCPCS | Low | Water chamber for humidifier, used with positive airway pressure device, replacement, each |
| A7047-HCPCS | Low | Oral interface used with respiratory suction pump, each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A7046. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A7046 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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