A9291 — Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment
A9291 is a HCPCS Level II code for prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment. It belongs to the Transportation, Medical & Surgical Supplies, Administrative section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusX
Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
Medically Unlikely Edits — units per day
The most units of A9291 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 1 unit MAI 2 — Date of Service Edit: Policy · Code Descriptor / CPT Instruction
- outpatient
- 1 unit MAI 2 — Date of Service Edit: Policy · Code Descriptor / CPT Instruction
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for A9291
- Long descriptor
- Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment
- Short descriptor
- Pres dig cog behav thera fda
- Added
- April 1, 2022
- BETOS
- Z2
- Pricing indicator
- 99 — Other
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Value not established.
Codes adjacent to A9291
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If A9291 is not quite right, the correct code is very often within a few positions of it.
- A9279Monitoring feature/device, stand-alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified
- A9280Alert or alarm device, not otherwise classified
- A9281Reaching/grabbing device, any type, any length, each
- A9282Wig, any type, each
- A9283Foot pressure off loading/supportive device, any type, each
- A9284Spirometer, non-electronic, includes all accessories
- A9285Inversion/eversion correction device
- A9286Hygienic item or device, disposable or non-disposable, any type, each
- A9292Prescription digital visual therapy, software-only, fda cleared, per course of treatment
- A9293Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)
- A9294Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment
- A9300Exercise equipment
- A9500Technetium tc-99m sestamibi, diagnostic, per study dose
- A9501Technetium tc-99m teboroxime, diagnostic, per study dose
- A9502Technetium tc-99m tetrofosmin, diagnostic, per study dose
- A9503Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries
Questions about A9291
What is HCPCS code A9291?
A9291 is a HCPCS Level II code for prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment. It sits in the Transportation, Medical & Surgical Supplies, Administrative section.
Does Medicare cover A9291?
The CMS HCPCS file marks A9291 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
How is A9291 paid under the physician fee schedule?
A9291 carries PFS status code X. Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.