A4224 HCPCS code: Supplies for maintenance of insulin infusion catheter, per week

A4224 is the HCPCS Level II code for supplies for maintenance of insulin infusion catheter, per week. The 2026 Medicare DMEPOS fee schedule pays $25.87 to $32.30 depending on the state. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 13 per day on DME suppliers. Medicare volume rose 1% from 2022 to 2024 (2,407,446 to 2,432,667 services). In 2024, 178 suppliers billed Medicare for A4224 (purchases), serving 62,201 beneficiaries; Florida, California, Texas accounted for 20% of services. Its average fee ranks 15 of 18 A42 codes (family range $0.61–$273.28); rural fees run 11% higher.

Code details

2026 Medicare DMEPOS fee schedule for A4224

How the A4224 fee compares

Who bills A4224 (2024)

Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.

Medicare utilization for A4224, 2022–2024

States with the most A4224 services (2024)

NCCI unit limits (MUE)

Medicare policy articles for this code

• A52507: External Infusion Pumps - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance

Covered diagnoses (460 ICD-10-CM codes)

The diagnoses most often listed as covered in the policy articles above:

Showing 10 of 460. The full list, non-covered diagnoses and CSV export are in Caduvo.

What changed for A4224

• 2026-01-01: Average state fee rose 2.6%: $25.52 to $26.19
• 2017-01-01: A4224 added to HCPCS Level II
• Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01

Frequently asked questions

What is HCPCS code A4224?

A4224 is the HCPCS Level II code for supplies for maintenance of insulin infusion catheter, per week. Short descriptor: "Supply insulin inf cath/wk".

How much does Medicare pay for A4224?

Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $25.87–$32.30. Rural fees can be higher.

Does Medicare cover A4224?

Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.

Which diagnoses support coverage for A4224?

Medicare policy articles that cite A4224 list 460 covered ICD-10-CM diagnosis codes across 1 article. The most cited include C91.00 (Acute lymphoblastic leukemia not having achieved remission), C91.01 (Acute lymphoblastic leukemia, in remission), C91.02 (Acute lymphoblastic leukemia, in relapse). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.

Did the Medicare fee for A4224 change in 2026?

The average non-rural state fee moved from $25.52 in 2025 to $26.19 in 2026 (+2.6%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.

How many units of A4224 can be billed per day?

13 on DME suppliers; 1 on outpatient hospital claims (NCCI medically unlikely edits).

Related A42 codes

• A4206 — Syringe with needle, sterile, 1 cc or less, each
• A4207 — Syringe with needle, sterile 2 cc, each
• A4208 — Syringe with needle, sterile 3 cc, each
• A4209 — Syringe with needle, sterile 5 cc or greater, each
• A4210 — Needle-free injection device, each
• A4211 — Supplies for self-administered injections
• A4212 — Non-coring needle or stylet with or without catheter
• A4213 — Syringe, sterile, 20 cc or greater, each
• A4215 — Needle, sterile, any size, each
• A4216 — Sterile water, saline and/or dextrose, diluent/flush, 10 ml ($0.53–$0.99)
• A4217 — Sterile water/saline, 500 ml ($2.18–$4.93)
• A4218 — Sterile saline or water, metered dose dispenser, 10 ml

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Next steps

• Run a reimbursement report for a device billed under A4224
• Watch A4224 for fee, coverage and descriptor changes
• Build a full Medicare revenue model for A4224

Sources: CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.

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