A7004 — Small volume nonfiltered pneumatic nebulizer, disposable
HCPCS Level II A-code · short descriptor: “Disposable nebulizer sml vol”
- 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.
A7004 Medicare fee schedule (April 2026)
NU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $1.51 to $2.15 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $2.01 | — |
| AL | $1.59 | $1.96 |
| AR | $1.59 | $1.96 |
| AZ | $1.57 | $2.15 |
| CA | $1.59 | $2.15 |
| CO | $1.51 | $1.96 |
| CT | $1.55 | $1.97 |
| DC | $1.56 | $2.15 |
| DE | $1.56 | $1.96 |
| FL | $1.59 | $1.96 |
| GA | $1.59 | $1.96 |
| HI | $2.08 | — |
| IA | $1.58 | $2.15 |
| ID | $1.51 | $2.15 |
| IL | $1.58 | $2.15 |
| IN | $1.58 | $2.15 |
| KS | $1.58 | $2.15 |
| KY | $1.59 | $1.96 |
| LA | $1.59 | $1.96 |
| MA | $1.55 | $1.97 |
| MD | $1.56 | $2.15 |
| ME | $1.55 | $2.01 |
| MI | $1.58 | $2.15 |
| MN | $1.58 | $2.15 |
| MO | $1.58 | $2.15 |
| MS | $1.59 | $1.96 |
| MT | $1.51 | $2.15 |
| NC | $1.59 | $1.96 |
| ND | $1.58 | $2.15 |
| NE | $1.58 | $2.15 |
| NH | $1.55 | $1.96 |
| NJ | $1.56 | $1.96 |
| NM | $1.57 | $1.96 |
| NV | $1.59 | $2.15 |
| NY | $1.56 | $1.96 |
| OH | $1.58 | $2.15 |
| OK | $1.57 | $1.96 |
| OR | $1.59 | $2.15 |
| PA | $1.56 | $1.96 |
| PR | $1.72 | — |
| RI | $1.55 | $1.96 |
| SC | $1.59 | $1.96 |
| SD | $1.58 | $2.15 |
| TN | $1.59 | $1.96 |
| TX | $1.57 | $1.96 |
| UT | $1.51 | $2.15 |
| VA | $1.59 | $2.15 |
| VI | $1.96 | — |
| VT | $1.55 | $1.96 |
| WA | $1.59 | $2.15 |
| WI | $1.58 | $2.15 |
| WV | $1.59 | $2.15 |
| WY | $1.51 | $2.15 |
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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