Key facts for A4239
- Medicare payment
- $273.28
- DMEPOS non-rural state fees
- Coverage code
- C
- carrier judgment, so the Medicare contractor decides coverage
- DME supplier MUE
- 3
- MAI 3
- NCCI PTP pairs
- 0
- practitioner file
- LCDs and articles
- 1 / 0
TL;DR
CMS describes HCPCS A4239, added in 2023, as "Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service". DMEPOS fees for A4239, a SU (supplies) item, run $273.28 in every contiguous state (floor $232.29, ceiling $273.28); KF (FDA class III device) $317.97 in every contiguous state (floor $270.27, ceiling $317.97) in the October 2026 file. Its 2026 Q4 MUEs per date of service: DME supplier 3 (MAI 3, CMS Policy). 1 active LCD lists A4239: L33822 (Glucose Monitors). OPPS status indicator Y: Non-implantable DME. HCPCS record: BETOS D1E (other DME); pricing indicator 34; type of service 9 (other medical items or services). Nearby codes: A4238, A4225, A4253, A4224.
A4239 descriptor and code status
The October 2026 HCPCS Level II file describes A4239 as “Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service”. It sits in the A section (transportation, medical and surgical supplies, administrative, miscellaneous and investigational), listed with the other A codes. Although searches often call it the "A4239 CPT code", A4239 is a HCPCS Level II code maintained by CMS, not an AMA CPT code; both go in the same procedure-code field on the claim.
| Field | Value |
|---|---|
| Short descriptor | Non-adju cgm supply allow |
| Added to HCPCS | 2023-01-01 |
| Last action | N (no maintenance), effective 2023-01-01 |
| Coverage code | C: carrier judgment, so the Medicare contractor decides coverage |
| Pricing indicator | 34: DMEPOS DME supplies (floors and ceilings) |
| BETOS category | D1E: other DME |
| Type of service | 9: other medical items or services |
Medicare payment for A4239
DMEPOS fees for A4239, a SU (supplies) item, run $273.28 in every contiguous state (floor $232.29, ceiling $273.28); KF (FDA class III device) $317.97 in every contiguous state (floor $270.27, ceiling $317.97) 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 P: bundled or excluded: no separate physician fee schedule payment. 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.
| Modifier | Floor / ceiling | Non-rural state range | Rural range | AK / HI / PR / VI |
|---|---|---|---|---|
| none | $232.29 / $273.28 | $273.28 (49 states) | — | AK $273.28, HI $273.28, PR $273.28, VI $273.28 |
| KF (FDA class III device) | $270.27 / $317.97 | $317.97 (49 states) | — | AK $317.97, HI $317.97, PR $317.97, VI $317.97 |
Hospital outpatient (OPPS Addendum B)
Status indicator Y (Non-implantable DME), with no separate OPPS payment rate.
Medically Unlikely Edits for A4239
Its 2026 Q4 MUEs per date of service: DME supplier 3 (MAI 3, CMS Policy). The DME supplier MUE is a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation.
| Setting | MUE (units/DOS) | MAI | CMS rationale |
|---|---|---|---|
| DME supplier | 3 | 3 Date of Service Edit: Clinical | CMS Policy |
The MUE lookup for A4239 shows every setting next to any other code on the same claim.
NCCI edits and add-on rules
No active practitioner PTP pair lists A4239 in v323r0.
A4239 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 A4239 against a second code to see whether the pair bundles and whether a modifier can separate the services.
Medicare coverage policies for A4239
1 active Local Coverage Determination and 0 billing and coding articles list A4239. Each applies only in its contractor's jurisdiction, and the article carries the diagnosis codes that support the item or service.
- Glucose Monitors, LCD L33822 · CGS Administrators, LLC; Noridian Healthcare Solutions, LLC
Denials to expect on A4239
the diagnosis or documentation does not meet the LCD or billing article that lists A4239
the KF payment modifier is missing or does not match the item
the claim lacks information needed to adjudicate the line, such as an order, NPI or required modifier
Where QuickIntell fits for A4239 claims
QuickAuth coordinates the requirement checks and documentation that DME claims for A4239 depend on, with human review of each case, and QuickRCM carries claim readiness and the CARC 50, 151 and modifier denials these items draw.
Frequently asked questions: HCPCS A4239
What does HCPCS code A4239 describe?
"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service" (short descriptor "Non-adju cgm supply allow"), in the A section (transportation, medical and surgical supplies, administrative, miscellaneous and investigational). Added 2023-01-01.
Is A4239 a CPT code?
No. A4239 is a CMS HCPCS Level II code; CPT codes are the AMA's five-character set. Searches for "A4239 CPT code" mean this Level II code.
What does Medicare pay for A4239?
DMEPOS fees for A4239, a SU (supplies) item, run $273.28 in every contiguous state (floor $232.29, ceiling $273.28); KF (FDA class III device) $317.97 in every contiguous state (floor $270.27, ceiling $317.97) in the October 2026 file.
How many units of A4239 can be billed per day?
Its 2026 Q4 MUEs per date of service: DME supplier 3 (MAI 3, CMS Policy). For the DME supplier MUE (MAI 3), units above 3 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.
Does Medicare cover A4239?
Coverage code C (carrier judgment, so the Medicare contractor decides coverage). 1 active LCD lists A4239: L33822 (Glucose Monitors).
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.
- HCPCS Level II alpha-numeric file, October 2026Version October 2026 · effective 2026-10-01 · file HCPC2026_OCT_ANWEB_09232026.txtSHA-256 c25240c63108756d…
- Medicare PFS national relative value file RVU26D (non-QPP), October 2026Version RVU26D, released 2026-08-26 · effective 2026-10-01 · file PPRRVU2026_Oct_nonQPP.csvSHA-256 4d0d3f19bd954ffc…
- Medicare PFS national relative value file RVU26D (qualifying APM participants), October 2026Version RVU26D, released 2026-08-26 · effective 2026-10-01 · file PPRRVU2026_Oct_QPP.csvSHA-256 59d3734704853936…
- DMEPOS fee schedule DME26-D, October 2026Version DME26-D (October 2026) · effective 2026-10-01 · file DMEPOS_OCT.csvSHA-256 a2824d58aadf4004…
- OPPS Addendum B, October 2026Version October 2026 · effective 2026-10-01 · file 508-compliant-version-2026_October_Web_Addendum_B.09.28.26.csvSHA-256 6ad7393a318bf1b9…
- Integrated Outpatient Code Editor v27.3 data tables: status and payment indicatorsVersion I/OCE v27.3 (October 2026) · effective 2026-10-01 · file Data_Status_Indicator.txtSHA-256 78f119ef0a435351…
- NCCI MUE table, practitioner services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_PractitionerServices_Eff_10-01-2026.csvSHA-256 ef038efaf902b7bd…
- NCCI MUE table, facility services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_OutpatientHospitalServices_Eff_10-01-2026.csvSHA-256 3af9f4e99cc587e2…
- NCCI MUE table, dme services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_DMESupplierServices_Eff_10-01-2026.csvSHA-256 6fa4fbba852f7b74…
- NCCI PTP edits, practitioner, v323r0 (four files)Version v323r0 (2026 Q4) · effective 2026-10-01 · file ccipra-v323r0-f1.TXTSHA-256 7793c0b6686c1e22…
- Medicare Coverage Database, current LCD exportVersion MCD release 2026-10-08 · effective 2026-10-04 · file lcd.csvSHA-256 9aee1bd7f14056b0…
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.