MyMedi-AI

A4344 — Indwelling catheter, foley type, two-way, all silicone or polyurethane, each

HCPCS Level II A-code · short descriptor: “Cath indw foley 2 way silicn”

Code system
HCPCS Level II
Family
A — Medical & surgical supplies, ambulance
Medicare coverage status
Special coverage instructions apply
DMEPOS payment category
Ostomy, tracheostomy & urological supplies
Prior authorization
Not on Medicare required-PA list
Face-to-face & WOPD
Not on the required list
MUE unit limit
3
Status
Active (HCPCS Level II October 2026)

Prior authorization

Not on the Medicare required-PA list (CMS Required Prior Authorization List — 74 items in force on 2026-10-25; 8 more from 2026-10-28; sources: CMS list updated 2026-01-13, CMS-6109-N (91 FR 47972)). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.

Order readiness — what the written order must contain

Every Medicare DMEPOS claim needs a Standard Written Order with all six elements (42 CFR 410.38(d)):

  • Beneficiary name or Medicare Beneficiary Identifier (MBI) (42 CFR 410.38(d)(1)(i)(A))
  • General description of the item (42 CFR 410.38(d)(1)(i)(B))
  • Quantity to be dispensed, if applicable (42 CFR 410.38(d)(1)(i)(C))
  • Order date (42 CFR 410.38(d)(1)(i)(D))
  • Treating practitioner name or NPI (42 CFR 410.38(d)(1)(i)(E))
  • Treating practitioner signature (42 CFR 410.38(d)(1)(i)(F))

Not on the F2F/WOPD list (CMS Required F2F & WOPD List — 83 items in force on 2026-10-25; 22 more from 2026-10-28; sources: CMS list effective 2026-04-13 (91 FR 1250), CMS-6109-N (91 FR 47972)). The standard written order must reach the supplier before claim submission.

Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.

A4344 Medicare fee schedule (October 2026)

Base (no modifier) Ostomy, tracheostomy & urological supplies

Medicare allowable ranges from $19.39 to $38.78 depending on state and rural status.

Former-CBA payment limits: ceiling $22.81 · floor $19.39

StateNon-ruralRural
AK$25.69—
AL$22.55—
AR$22.81—
AZ$22.81—
CA$22.81—
CO$22.59—
CT$19.39—
DC$19.39—
DE$19.39—
FL$22.81—
GA$19.39—
HI$27.45—
IA$22.81—
ID$19.39—
IL$19.59—
IN$22.81—
KS$22.81—
KY$22.81—
LA$22.81—
MA$21.66—
MD$21.93—
ME$22.81—
MI$22.81—
MN$21.85—
MO$20.67—
MS$20.87—
MT$19.39—
NC$20.46—
ND$22.81—
NE$22.81—
NH$22.81—
NJ$19.39—
NM$22.81—
NV$22.81—
NY$22.81—
OH$22.81—
OK$22.81—
OR$22.81—
PA$19.39—
PR$38.78—
RI$20.04—
SC$20.27—
SD$21.86—
TN$20.88—
TX$19.39—
UT$19.39—
VA$22.81—
VI$22.81—
VT$22.81—
WA$22.81—
WI$22.81—
WV$22.81—
WY$19.39—
Amounts are the Medicare DMEPOS fee-schedule allowables effective October 2026 (CMS DMEPOS Fee Schedule October 2026 (DME26-D)). 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.

Unit limit (MUE)

Medicare's Medically Unlikely Edit caps A4344 at 3 units per date of service (clinical). Units above the MUE deny — typically as CO-151. Rationale: Published Contractor Policy.

Common denial codes to watch

Related A-codes

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