A4221 — Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately)
HCPCS Level II A-code · short descriptor: “Supp non-insulin inf cath/wk”
- Code system
- HCPCS Level II
- Family
- A — Medical & surgical supplies, ambulance
- Medicare coverage status
- Carrier judgment — coverage decided by the DME MAC
- DMEPOS payment category
- Supplies
- Prior authorization
- Not on Medicare required-PA list
- Status
- Active (April 2026 HCPCS)
Prior authorization
Not on the Medicare required-PA list as of the January 13, 2026 update (74 items). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.
A4221 Medicare fee schedule (April 2026)
Base (no modifier) Supplies
Medicare allowable ranges from $25.87 to $32.30 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $28.95 | — |
| AL | $25.87 | $29.07 |
| AR | $25.87 | $29.07 |
| AZ | $25.87 | $28.80 |
| CA | $25.87 | $28.80 |
| CO | $25.87 | $29.07 |
| CT | $25.87 | $29.07 |
| DC | $25.87 | $29.07 |
| DE | $25.87 | $29.07 |
| FL | $25.87 | $29.07 |
| GA | $25.87 | $29.07 |
| HI | $30.06 | — |
| IA | $25.87 | $28.80 |
| ID | $25.87 | $28.80 |
| IL | $25.87 | $29.07 |
| IN | $25.87 | $29.07 |
| KS | $25.87 | $28.80 |
| KY | $25.87 | $29.07 |
| LA | $25.87 | $29.07 |
| MA | $25.87 | $29.07 |
| MD | $25.87 | $29.07 |
| ME | $25.87 | $29.07 |
| MI | $25.87 | $29.07 |
| MN | $25.87 | $29.07 |
| MO | $25.87 | $28.80 |
| MS | $25.87 | $29.07 |
| MT | $25.87 | $28.80 |
| NC | $25.87 | $29.07 |
| ND | $25.87 | $28.80 |
| NE | $25.87 | $28.80 |
| NH | $25.87 | $29.07 |
| NJ | $25.87 | $29.07 |
| NM | $25.87 | $29.07 |
| NV | $25.87 | $28.80 |
| NY | $25.87 | $29.07 |
| OH | $25.87 | $29.07 |
| OK | $25.87 | $29.07 |
| OR | $25.87 | $28.80 |
| PA | $25.87 | $29.07 |
| PR | $32.30 | — |
| RI | $25.87 | $29.07 |
| SC | $25.87 | $29.07 |
| SD | $25.87 | $28.80 |
| TN | $25.87 | $29.07 |
| TX | $25.87 | $29.07 |
| UT | $25.87 | $28.80 |
| VA | $25.87 | $29.07 |
| VI | $29.07 | — |
| VT | $25.87 | $29.07 |
| WA | $25.87 | $28.80 |
| WI | $25.87 | $29.07 |
| WV | $25.87 | $29.07 |
| WY | $25.87 | $28.80 |
Amounts are the Medicare DMEPOS fee-schedule allowables effective April 2026.
Medicare typically pays 80% of the allowable after the Part B deductible; the patient owes 20%.
A 2% sequestration reduction applies to the Medicare share. Former competitive-bidding-area
adjustments and non-continental rates can differ — verify with your DME MAC.
Common denial codes to watch
Related A-codes
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