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A4372 — Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each

HCPCS Level II A-code · short descriptor: “Skin barrier solid 4x4 equiv”

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
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.

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 (April 13, 2026 update — 83 items). The standard written order must reach the supplier before claim submission.

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

A4372 Medicare fee schedule (April 2026)

Base (no modifier) Ostomy, tracheostomy & urological supplies

Medicare allowable ranges from $5.99 to $6.57 depending on state and rural status.

Former-CBA payment limits: ceiling $5.99 · floor $5.09

StateNon-ruralRural
AK$6.02
AL$5.99
AR$5.99
AZ$5.99
CA$5.99
CO$5.99
CT$5.99
DC$5.99
DE$5.99
FL$5.99
GA$5.99
HI$6.47
IA$5.99
ID$5.99
IL$5.99
IN$5.99
KS$5.99
KY$5.99
LA$5.99
MA$5.99
MD$5.99
ME$5.99
MI$5.99
MN$5.99
MO$5.99
MS$5.99
MT$5.99
NC$5.99
ND$5.99
NE$5.99
NH$5.99
NJ$5.99
NM$5.99
NV$5.99
NY$5.99
OH$5.99
OK$5.99
OR$5.99
PA$5.99
PR$6.57
RI$5.99
SC$5.99
SD$5.99
TN$5.99
TX$5.99
UT$5.99
VA$5.99
VI$5.99
VT$5.99
WA$5.99
WI$5.99
WV$5.99
WY$5.99
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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