A4604 — Tubing with integrated heating element for use with positive airway pressure device
HCPCS Level II A-code · short descriptor: “Tubing with heating element”
- 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
- Inexpensive or routinely purchased
- 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.
A4604 Medicare fee schedule (April 2026)
NU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $49.31 to $76.79 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $68.58 | — |
| AL | $49.36 | $68.75 |
| AR | $49.36 | $68.75 |
| AZ | $49.52 | $68.75 |
| CA | $50.66 | $68.75 |
| CO | $50.59 | $68.75 |
| CT | $52.55 | $68.75 |
| DC | $49.98 | $68.75 |
| DE | $49.98 | $68.75 |
| FL | $49.36 | $68.75 |
| GA | $49.36 | $68.75 |
| HI | $68.58 | — |
| IA | $49.31 | $68.75 |
| ID | $50.59 | $68.75 |
| IL | $49.80 | $68.75 |
| IN | $49.80 | $68.75 |
| KS | $49.31 | $68.75 |
| KY | $49.36 | $68.75 |
| LA | $49.36 | $68.75 |
| MA | $52.55 | $68.75 |
| MD | $49.98 | $68.75 |
| ME | $52.55 | $68.75 |
| MI | $49.80 | $68.75 |
| MN | $49.31 | $68.75 |
| MO | $49.31 | $68.75 |
| MS | $49.36 | $68.75 |
| MT | $50.59 | $68.75 |
| NC | $49.36 | $68.75 |
| ND | $49.31 | $68.75 |
| NE | $49.31 | $68.75 |
| NH | $52.55 | $68.75 |
| NJ | $49.98 | $68.75 |
| NM | $49.52 | $68.75 |
| NV | $50.66 | $68.75 |
| NY | $49.98 | $68.75 |
| OH | $49.80 | $68.75 |
| OK | $49.52 | $68.75 |
| OR | $50.66 | $68.75 |
| PA | $49.98 | $68.75 |
| PR | $76.79 | — |
| RI | $52.55 | $68.75 |
| SC | $49.36 | $68.75 |
| SD | $49.31 | $68.75 |
| TN | $49.36 | $68.75 |
| TX | $49.52 | $68.75 |
| UT | $50.59 | $68.75 |
| VA | $49.36 | $68.75 |
| VI | $68.58 | — |
| VT | $52.55 | $68.75 |
| WA | $50.66 | $68.75 |
| WI | $49.80 | $68.75 |
| WV | $49.36 | $68.75 |
| WY | $50.59 | $68.75 |
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
Bill A4604 with confidence
MyMedi-AI scrubs whole claims against NCCI pairs, MUE limits, modifier rules, and PA flags before you submit — built for DME teams, no PHI stored on our servers.
Start free trial Run a CMS-0057-F readiness checkPrefer DIY compliance? Self-audit documentation kits for DME suppliers →