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A5082 — Continent device; catheter for continent stoma

HCPCS Level II A-code · short descriptor: “Continent stoma catheter”

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 2026-10-16; 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 2026-10-16; 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.

A5082 Medicare fee schedule (October 2026)

Base (no modifier) Ostomy, tracheostomy & urological supplies

Medicare allowable ranges from $2.15 to $16.96 depending on state and rural status.

Former-CBA payment limits: ceiling $16.96 · floor $14.42

StateNon-ruralRural
AK$14.17—
AL$14.42—
AR$16.96—
AZ$14.42—
CA$14.42—
CO$16.96—
CT$16.96—
DC$16.96—
DE$16.96—
FL$14.42—
GA$16.96—
HI$15.13—
IA$14.42—
ID$14.46—
IL$16.96—
IN$14.42—
KS$16.96—
KY$14.42—
LA$16.96—
MA$16.96—
MD$16.96—
ME$16.96—
MI$16.96—
MN$16.10—
MO$15.48—
MS$14.42—
MT$16.96—
NC$16.02—
ND$16.96—
NE$16.96—
NH$16.96—
NJ$16.96—
NM$16.96—
NV$14.42—
NY$14.42—
OH$16.96—
OK$16.96—
OR$14.46—
PA$16.96—
PR$2.15—
RI$16.96—
SC$14.42—
SD$16.96—
TN$14.42—
TX$16.96—
UT$16.96—
VA$14.42—
VI$14.42—
VT$16.96—
WA$14.46—
WI$16.96—
WV$16.96—
WY$16.96—
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 A5082 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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