A4222 — Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)
HCPCS Level II A-code · short descriptor: “Infusion supplies with pump”
- 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.
A4222 Medicare fee schedule (April 2026)
Base (no modifier) Supplies
Medicare allowable ranges from $49.07 to $62.94 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $56.32 | — |
| AL | $49.07 | $57.84 |
| AR | $49.07 | $57.84 |
| AZ | $49.07 | $56.00 |
| CA | $49.07 | $56.00 |
| CO | $49.07 | $57.84 |
| CT | $49.07 | $57.84 |
| DC | $49.07 | $56.56 |
| DE | $49.07 | $57.84 |
| FL | $49.07 | $56.56 |
| GA | $49.07 | $57.84 |
| HI | $58.53 | — |
| IA | $49.07 | $56.00 |
| ID | $49.07 | $56.00 |
| IL | $49.07 | $56.56 |
| IN | $49.07 | $57.84 |
| KS | $49.07 | $56.00 |
| KY | $49.07 | $57.84 |
| LA | $49.07 | $57.84 |
| MA | $49.07 | $57.84 |
| MD | $49.07 | $56.56 |
| ME | $49.07 | $57.84 |
| MI | $49.07 | $57.84 |
| MN | $49.07 | $57.84 |
| MO | $49.07 | $56.00 |
| MS | $49.07 | $57.84 |
| MT | $49.07 | $56.00 |
| NC | $49.07 | $57.52 |
| ND | $49.07 | $56.00 |
| NE | $49.07 | $56.00 |
| NH | $49.07 | $57.84 |
| NJ | $49.07 | $57.84 |
| NM | $49.07 | $57.84 |
| NV | $49.07 | $56.00 |
| NY | $49.07 | $57.84 |
| OH | $49.07 | $56.56 |
| OK | $49.07 | $57.84 |
| OR | $49.07 | $56.00 |
| PA | $49.07 | $57.84 |
| PR | $62.94 | — |
| RI | $49.07 | $57.84 |
| SC | $49.07 | $57.84 |
| SD | $49.07 | $56.00 |
| TN | $49.07 | $57.84 |
| TX | $49.07 | $56.56 |
| UT | $49.07 | $56.00 |
| VA | $49.07 | $56.56 |
| VI | $57.84 | — |
| VT | $49.07 | $57.84 |
| WA | $49.07 | $56.00 |
| WI | $49.07 | $57.84 |
| WV | $49.07 | $56.56 |
| WY | $49.07 | $56.00 |
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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