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A4239 — Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service

HCPCS Level II A-code · short descriptor: “Non-adju cgm supply allow”

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.

A4239 Medicare fee schedule (April 2026)

Base (no modifier) Supplies

Medicare allowable: $273.28 in all listed states.

Former-CBA payment limits: ceiling $273.28 · floor $232.29

StateNon-ruralRural
AK$273.28
AL$273.28
AR$273.28
AZ$273.28
CA$273.28
CO$273.28
CT$273.28
DC$273.28
DE$273.28
FL$273.28
GA$273.28
HI$273.28
IA$273.28
ID$273.28
IL$273.28
IN$273.28
KS$273.28
KY$273.28
LA$273.28
MA$273.28
MD$273.28
ME$273.28
MI$273.28
MN$273.28
MO$273.28
MS$273.28
MT$273.28
NC$273.28
ND$273.28
NE$273.28
NH$273.28
NJ$273.28
NM$273.28
NV$273.28
NY$273.28
OH$273.28
OK$273.28
OR$273.28
PA$273.28
PR$273.28
RI$273.28
SC$273.28
SD$273.28
TN$273.28
TX$273.28
UT$273.28
VA$273.28
VI$273.28
VT$273.28
WA$273.28
WI$273.28
WV$273.28
WY$273.28

KF Supplies

Medicare allowable: $317.97 in all listed states.

Former-CBA payment limits: ceiling $317.97 · floor $270.27

StateNon-ruralRural
AK$317.97
AL$317.97
AR$317.97
AZ$317.97
CA$317.97
CO$317.97
CT$317.97
DC$317.97
DE$317.97
FL$317.97
GA$317.97
HI$317.97
IA$317.97
ID$317.97
IL$317.97
IN$317.97
KS$317.97
KY$317.97
LA$317.97
MA$317.97
MD$317.97
ME$317.97
MI$317.97
MN$317.97
MO$317.97
MS$317.97
MT$317.97
NC$317.97
ND$317.97
NE$317.97
NH$317.97
NJ$317.97
NM$317.97
NV$317.97
NY$317.97
OH$317.97
OK$317.97
OR$317.97
PA$317.97
PR$317.97
RI$317.97
SC$317.97
SD$317.97
TN$317.97
TX$317.97
UT$317.97
VA$317.97
VI$317.97
VT$317.97
WA$317.97
WI$317.97
WV$317.97
WY$317.97
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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