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A4618 — Breathing circuits

HCPCS Level II A-code

Code system
HCPCS Level II
Family
A — Medical & surgical supplies, ambulance
Medicare coverage status
Special coverage instructions apply
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.

A4618 Medicare fee schedule (April 2026)

NU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $10.78 to $31.06 depending on state and rural status.

Former-CBA payment limits: ceiling $12.68 · floor $10.78

StateNon-ruralRural
AK$29.04
AL$10.78
AR$12.68
AZ$10.78
CA$12.68
CO$12.68
CT$12.68
DC$12.68
DE$12.68
FL$10.78
GA$11.65
HI$31.06
IA$12.43
ID$10.78
IL$12.68
IN$10.78
KS$12.43
KY$12.68
LA$12.68
MA$12.68
MD$12.68
ME$12.68
MI$12.68
MN$10.97
MO$12.68
MS$10.78
MT$10.78
NC$10.78
ND$12.68
NE$12.43
NH$12.68
NJ$12.68
NM$12.59
NV$10.78
NY$12.68
OH$10.78
OK$12.56
OR$10.91
PA$12.68
PR$13.77
RI$12.68
SC$12.68
SD$12.68
TN$10.78
TX$10.78
UT$12.68
VA$12.68
VI$12.68
VT$12.68
WA$10.91
WI$10.78
WV$10.78
WY$12.68

RR — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $1.25 to $3.11 depending on state and rural status.

Former-CBA payment limits: ceiling $1.47 · floor $1.25

StateNon-ruralRural
AK$2.86
AL$1.25
AR$1.47
AZ$1.47
CA$1.47
CO$1.47
CT$1.47
DC$1.47
DE$1.47
FL$1.25
GA$1.25
HI$3.11
IA$1.25
ID$1.25
IL$1.34
IN$1.25
KS$1.25
KY$1.25
LA$1.47
MA$1.47
MD$1.47
ME$1.47
MI$1.47
MN$1.25
MO$1.47
MS$1.25
MT$1.25
NC$1.25
ND$1.47
NE$1.25
NH$1.47
NJ$1.47
NM$1.25
NV$1.47
NY$1.47
OH$1.25
OK$1.25
OR$1.25
PA$1.47
PR$1.69
RI$1.47
SC$1.25
SD$1.47
TN$1.25
TX$1.25
UT$1.47
VA$1.47
VI$1.47
VT$1.47
WA$1.25
WI$1.25
WV$1.25
WY$1.47

UE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $8.08 to $23.31 depending on state and rural status.

Former-CBA payment limits: ceiling $9.51 · floor $8.08

StateNon-ruralRural
AK$21.80
AL$8.08
AR$9.51
AZ$8.08
CA$9.51
CO$9.51
CT$9.51
DC$9.51
DE$9.51
FL$8.08
GA$8.79
HI$23.31
IA$9.33
ID$8.08
IL$9.51
IN$8.08
KS$9.33
KY$9.51
LA$9.51
MA$9.51
MD$9.51
ME$9.51
MI$9.51
MN$8.18
MO$9.51
MS$8.08
MT$8.08
NC$8.08
ND$9.51
NE$9.33
NH$9.51
NJ$9.51
NM$9.44
NV$8.08
NY$9.51
OH$8.08
OK$9.41
OR$8.16
PA$9.51
PR$10.36
RI$9.51
SC$9.51
SD$9.51
TN$8.08
TX$8.08
UT$9.51
VA$9.51
VI$9.51
VT$9.51
WA$8.16
WI$8.08
WV$8.08
WY$9.51
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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