CurrentSelectHealthPolicy 14

Surgical Trays and Supplies

Defines SelectHealth's reimbursement stance for surgical trays and supplies for commercial, Medicare (CMS), and Medicaid (Community Care) plans, specifying when separate payment is allowed or denied and coding/reporting requirements.

Policy Summary

PayerSelectHealth

PolicySurgical Trays and Supplies

Policy CodePolicy 14

Change TypeNo material change

Effective DateJan 1, 2023

Next Review DateJan 7, 2025

Key ActionDo not bill A4550 or A4649 separately; they are bundled and will be denied — report specific HCPCS Level II or appropriate unlisted HCPCS with documentation instead of CPT 99070.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

A4550 denied as bundledSurgical tray code treatment

A4649 denied as bundledMiscellaneous surgical supply code treatment

99070 deniedUse of CPT 99070 discouraged

Since 1/1/05Policy implementation date

Commercial, Medicare, MedicaidPlans covered

Coverage criteria for surgical trays and supplies

Separate payment criteria and denials for tray and supply codes

SelectHealth follows RBRVS practice-expense methodology and treats costs represented by surgical tray and miscellaneous supply codes as included in procedure reimbursements; therefore separate payment is not allowed for these codes.

ALL of the following

Denied when billed separately
- Code A4550 (Surgical trays) is considered bundled into the procedure reimbursement and will be denied if billed separately.
- Code A4649 (Surgical supply; miscellaneous) is considered bundled into the procedure reimbursement and will be denied if billed separately.

ALL of the following

Policy Summary

PayerSelectHealth

PolicySurgical Trays and Supplies

Policy CodePolicy 14

Change TypeNo material change

Effective DateJan 1, 2023

Next Review DateJan 7, 2025

Key ActionDo not bill A4550 or A4649 separately; they are bundled and will be denied — report specific HCPCS Level II or appropriate unlisted HCPCS with documentation instead of CPT 99070.

SourceLink

On This Page

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Codes and coding guidance

Supply and tray codesHCPCSNot Covered

A4550	Surgical trays
A4649	Surgical supply; miscellaneous
99070	Supplies and materials (nonspecific) — denied
99072	Additional supplies during Public Health Emergency (listed)

Unlisted HCPCS option when no specific codeHCPCS

A9999	Miscellaneous DME supply or accessory; not otherwise specified
B9999	NOC for parenteral supplies
J9999	NOC, antineoplastic drug

Use of CPT 99070 (inv-04)

StatusDenied — CPT 99070 will be denied by SelectHealth.

Required reportingReport specific HCPCS Level II supplies codes instead of CPT 99070.

If no specific codeReport an appropriate unlisted HCPCS Level II (e.g., A9999, B9999, J9999) with medical documentation or invoices for consideration.

Rationale99070 may allow duplicate payment or payment for non-covered services/supplies; SelectHealth implemented this requirement effective Jan 1, 2005.

Billing, prior authorization, and provider guidance

Billing Rule

Do not bill A4550/A4649 separately; CPT 99070 denied — use HCPCS Level II or unlisted with documentation

Do not bill HCPCS codes A4550 (surgical trays) or A4649 (miscellaneous surgical supply) separately; SelectHealth treats these codes as bundled into the procedure reimbursement and will deny them. Do not report CPT 99070 — it will be denied; report specific HCPCS Level II supply codes instead, or an appropriate unlisted HCPCS with supporting medical documentation or invoices when no specific HCPCS exists.

A4550 and A4649 are considered bundled and will be denied if billed separately.
CPT 99070 will be denied — report a specific HCPCS Level II supply code.
If no specific HCPCS code exists, report an unlisted HCPCS for the section (e.g., A9999, B9999, J9999) with medical documentation or invoices for consideration.

Definitions related to surgical supplies and trays

Surgical supplies / trays (inv-06)

Included itemsScalpels, syringes, dressings, trays containing supplies/instruments (and other items such as medicine glass and instruments) necessary to perform a procedure.

Bundled statusSurgical trays and miscellaneous surgical supply costs (codes A4550 and A4649) are considered included in procedure reimbursement and will be denied if billed separately.

ScopeConsidered included in surgical procedures, Evaluation and Management services, and all other procedures or services provided in an office-based setting.

Payment basisSelectHealth follows RBRVS practice-expense methodology; costs represented by tray/supply codes are captured in the procedure MAF, so no separate payment is made.