A4593 HCPCS code: Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller
A4593 is the HCPCS Level II code for neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller. The 2026 Medicare DMEPOS fee schedule pays $44.89 to $75.93 (RR, rental (monthly)) 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 1 per day on DME suppliers.
Code details
| Field | Value |
|---|---|
| Section | A codes — Transportation, medical/surgical supplies and miscellaneous |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 36 — DMEPOS: capped rental item |
| BETOS category | D1E — Other durable medical equipment |
| Added | 2024-04-01 |
| Last action effective | 2025-04-01 |
2026 Medicare DMEPOS fee schedule for A4593
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| RR | rental (monthly) | $44.89 | $75.93 | — | — |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | RR | $50.64 | — |
| AL | RR | $52.81 | — |
| AR | RR | $51.86 | — |
| AZ | RR | $47.14 | — |
| CA | RR | $44.89 | — |
| CO | RR | $52.38 | — |
| CT | RR | $52.81 | — |
| DC | RR | $48.31 | — |
| DE | RR | $52.81 | — |
| FL | RR | $52.81 | — |
| GA | RR | $52.81 | — |
| HI | RR | $75.93 | — |
| IA | RR | $50.32 | — |
| ID | RR | $52.81 | — |
| IL | RR | $49.11 | — |
| IN | RR | $51.33 | — |
| KS | RR | $51.70 | — |
| KY | RR | $47.88 | — |
| LA | RR | $46.71 | — |
| MA | RR | $52.81 | — |
| MD | RR | $52.81 | — |
| ME | RR | $52.81 | — |
| MI | RR | $52.81 | — |
| MN | RR | $50.80 | — |
| MO | RR | $51.70 | — |
| MS | RR | $52.81 | — |
| MT | RR | $52.81 | — |
| NC | RR | $52.81 | — |
| ND | RR | $52.81 | — |
| NE | RR | $51.70 | — |
| NH | RR | $52.81 | — |
| NJ | RR | $52.81 | — |
| NM | RR | $52.81 | — |
| NV | RR | $50.37 | — |
| NY | RR | $48.49 | — |
| OH | RR | $52.28 | — |
| OK | RR | $49.55 | — |
| OR | RR | $48.64 | — |
| PA | RR | $44.89 | — |
| PR | RR | $50.85 | — |
| RI | RR | $52.81 | — |
| SC | RR | $52.81 | — |
| SD | RR | $52.81 | — |
| TN | RR | $51.45 | — |
| TX | RR | $50.99 | — |
| UT | RR | $52.81 | — |
| VA | RR | $49.37 | — |
| VI | RR | $48.49 | — |
| VT | RR | $52.81 | — |
| WA | RR | $52.81 | — |
| WI | RR | $52.81 | — |
| WV | RR | $52.36 | — |
| WY | RR | $52.81 | — |
How the A4593 fee compares
| Measure | Value |
|---|---|
| Rank among 1 A45 codes billed RR (lowest = 1) | 1 |
| Family fee range (average of state fees) | $51.71–$51.71 |
| Rural fee uplift | — |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 1 | Code Descriptor / CPT Instruction |
What changed for A4593
- 2024-04-01: A4593 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 A4593?
A4593 is the HCPCS Level II code for neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller. Short descriptor: "Neuromod sti sys adj rehab".
How much does Medicare pay for A4593?
Under the 2026 DMEPOS fee schedule, non-rural state fees are RR (rental (monthly)): $44.89–$75.93. Rural fees can be higher.
Does Medicare cover A4593?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of A4593 can be billed per day?
1 on DME suppliers (NCCI medically unlikely edits).
Related A45 codes
- A4500 — Surgical stockings below knee length, each
- A4510 — Surgical stockings full length, each
- A4520 — Incontinence garment, any type, (e.g., brief, diaper), each
- A4540 — Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm
- A4541 — Monthly supplies for use of device coded at e0733 ($40.40–$49.25)
- A4542 — Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist ($526.85–$526.85)
- A4543 — Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month
- A4544 — Electrode for external lower extremity nerve stimulator for restless legs syndrome ($6.34–$6.34)
- A4545 — Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month ($38.21–$55.51)
- A4550 — Surgical trays
- A4553 — Non-disposable underpads, all sizes
- A4554 — Disposable underpads, all sizes
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Next steps
- Run a reimbursement report for a device billed under A4593
- Watch A4593 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A4593
Sources: CMS HCPCS Level II release October 2025; 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.