Skip to main content
HCPCS A4224 · Level II · A code

A4224: Supplies for maintenance of insulin infusion catheter, per week, HCPCS Level II A code

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: HCPCS Level II file: October 2026 (effective October 1, 2026); PFS relative value file: RVU26D, released August 26, 2026 (effective October 1, 2026); DMEPOS fee schedule: DME26-D (October 2026) (effective October 1, 2026); NCCI MUE tables: 2026 Q4 (effective October 1, 2026); NCCI PTP edits: v323r0 (2026 Q4) (effective October 1, 2026); OPPS Addendum B: October 2026 (effective October 1, 2026); Medicare Coverage Database LCD export: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: January 1, 2027 (quarterly update) for the HCPCS Level II file and DMEPOS fee schedule and NCCI MUE tables and NCCI PTP edits and OPPS Addendum B; RVU27A with the CY2027 PFS final rule, effective January 1, 2027 for the PFS relative value file; weekly, every Thursday for the Medicare Coverage Database LCD export.

Key facts for A4224

Medicare payment
$25.87
DMEPOS non-rural state fees
Coverage code
C
carrier judgment, so the Medicare contractor decides coverage
DME supplier MUE
13
MAI 2
OPPS status
SI N
Items and Services packaged into APC rates
NCCI PTP pairs
0
practitioner file
LCDs and articles
1 / 0

TL;DR

CMS describes HCPCS A4224, added in 2017, as "Supplies for maintenance of insulin infusion catheter, per week". DMEPOS fees for A4224, a SU (supplies) item, run $25.87 in every contiguous state, rural $28.80 to $29.07 in the October 2026 file. Its 2026 Q4 MUEs per date of service: practitioner 0 (MAI 3, CMS Policy); hospital outpatient 1 (MAI 2, Code Descriptor / CPT Instruction); DME supplier 13 (MAI 2, Code Descriptor / CPT Instruction). 1 active LCD lists A4224: L33794 (External Infusion Pumps). OPPS status indicator N: Items and Services packaged into APC rates. HCPCS record: BETOS D1E (other DME); pricing indicator 34; type of service P (lump-sum purchase of DME, prosthetics or orthotics). Nearby codes: A4225, A4222, A4221, A4220.

A4224 descriptor and code status

The October 2026 HCPCS Level II file describes A4224 as “Supplies for maintenance of insulin infusion catheter, per week”. It sits in the A section (transportation, medical and surgical supplies, administrative, miscellaneous and investigational), listed with the other A codes.

HCPCS file attributes of A4224
FieldValue
Short descriptorSupply insulin inf cath/wk
Added to HCPCS2017-01-01
Last actionN (no maintenance), effective 2017-01-01
Coverage codeC: carrier judgment, so the Medicare contractor decides coverage
Pricing indicator34: DMEPOS DME supplies (floors and ceilings)
BETOS categoryD1E: other DME
Type of serviceP: lump-sum purchase of DME, prosthetics or orthotics

Medicare payment for A4224

DMEPOS fees for A4224, a SU (supplies) item, run $25.87 in every contiguous state, rural $28.80 to $29.07 in the October 2026 file. The amounts below are national figures from the October 2026 CMS files; the contractor applies the locality, rural or state adjustment and the beneficiary's cost sharing.

Physician fee schedule (RVU26D)

Status X: statutory exclusion: not a physician service under the fee schedule. Global period XXX (global surgery concept does not apply); PC/TC indicator 9 (professional/technical concept does not apply).

DMEPOS fee schedule (DME26-D)

Jurisdiction D (DME MAC), payment category SU (supplies). Fees are set per state; AK, HI, PR and VI are not subject to the national ceiling and floor and are listed separately. A rural fee applies only in ZIP codes on the CMS rural ZIP list.

DMEPOS fees for A4224 by modifier
ModifierFloor / ceilingNon-rural state rangeRural rangeAK / HI / PR / VI
none—$25.87 (49 states)$28.80 (AZ, CA, IA…) to $29.07 (AL, AR, CO…)AK $28.95, HI $30.06, PR $32.30, VI $29.07

Hospital outpatient (OPPS Addendum B)

Status indicator N (Items and Services packaged into APC rates), with no separate OPPS payment rate.

Medically Unlikely Edits for A4224

Its 2026 Q4 MUEs per date of service: practitioner 0 (MAI 3, CMS Policy); hospital outpatient 1 (MAI 2, Code Descriptor / CPT Instruction); DME supplier 13 (MAI 2, Code Descriptor / CPT Instruction). The DME supplier MUE is a date-of-service policy edit: units above the limit deny even when split across lines, and appeals rarely succeed.

MUE values for A4224 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services03 Date of Service Edit: ClinicalCMS Policy
Facility outpatient hospital12 Date of Service Edit: PolicyCode Descriptor / CPT Instruction
DME supplier132 Date of Service Edit: PolicyCode Descriptor / CPT Instruction

The MUE lookup for A4224 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

No active practitioner PTP pair lists A4224 in v323r0.

A4224 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Pair counts show exposure, not the answer for one claim. Check A4224 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for A4224

1 active Local Coverage Determination and 0 billing and coding articles list A4224. Each applies only in its contractor's jurisdiction, and the article carries the diagnosis codes that support the item or service.

Denials to expect on A4224

CARC 50 · N115

the diagnosis or documentation does not meet the LCD or billing article that lists A4224

CARC 151 · N362

units of A4224 exceed the DME supplier MUE of 13 per date of service

CARC 4

the modifier reported is inconsistent with the code

CARC 16

the claim lacks information needed to adjudicate the line, such as an order, NPI or required modifier

Where QuickIntell fits for A4224 claims

QuickAuth coordinates the requirement checks and documentation that DME claims for A4224 depend on, with human review of each case, and QuickRCM carries claim readiness and the CARC 50, 151 and modifier denials these items draw.

See QuickAuth for requirement checksSee QuickRCM for denial follow-upBook a meeting

Frequently asked questions: HCPCS A4224

What does HCPCS code A4224 describe?

"Supplies for maintenance of insulin infusion catheter, per week" (short descriptor "Supply insulin inf cath/wk"), in the A section (transportation, medical and surgical supplies, administrative, miscellaneous and investigational). Added 2017-01-01.

Is A4224 a CPT code?

No. A4224 is a CMS HCPCS Level II code; CPT codes are the AMA's five-character set. Searches for "A4224 CPT code" mean this Level II code.

What does Medicare pay for A4224?

DMEPOS fees for A4224, a SU (supplies) item, run $25.87 in every contiguous state, rural $28.80 to $29.07 in the October 2026 file.

How many units of A4224 can be billed per day?

Its 2026 Q4 MUEs per date of service: practitioner 0 (MAI 3, CMS Policy); hospital outpatient 1 (MAI 2, Code Descriptor / CPT Instruction); DME supplier 13 (MAI 2, Code Descriptor / CPT Instruction). For the DME supplier MUE (MAI 2), units above 13 deny for the whole day as a policy limit; denials arrive as CARC 151.

Does Medicare cover A4224?

Coverage code C (carrier judgment, so the Medicare contractor decides coverage). 1 active LCD lists A4224: L33794 (External Infusion Pumps).

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

This page is an operational reference compiled from CMS publications: the HCPCS Level II file, the physician, DMEPOS and clinical laboratory fee schedules, OPPS and ASC addenda, NCCI MUE, PTP and add-on edit tables and the Medicare Coverage Database. Amounts are Medicare national figures before locality and state adjustment; Medicaid and commercial payers set their own. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.