A4595 HCPCS code: Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)
A4595 is the HCPCS Level II code for electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes). The 2026 Medicare DMEPOS fee schedule pays $11.40 to $31.64 depending on the state. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 6 per day on DME suppliers. Medicare volume fell 8% from 2022 to 2024 (15,965 to 14,728 services). In 2024, 204 suppliers billed Medicare for A4595 (purchases), serving 1,928 beneficiaries; Ohio, California, Pennsylvania accounted for 57% of services. Its average fee ranks 6 of 14 A45 codes (family range $0.13–$1,672.60); rural fees run 97% higher.
Code details
| Field | Value |
|---|---|
| Section | A codes — Transportation, medical/surgical supplies and miscellaneous |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 34 — DMEPOS: supplies necessary for the effective use of DME |
| BETOS category | D1E — Other durable medical equipment |
| Added | 1996-01-01 |
| Last action effective | 2003-01-01 |
2026 Medicare DMEPOS fee schedule for A4595
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $11.40 | $31.64 | — | — |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $27.22 | — |
| AL | — | $13.24 | $27.55 |
| AR | — | $13.24 | $27.55 |
| AZ | — | $12.84 | $27.22 |
| CA | — | $11.40 | $27.22 |
| CO | — | $12.97 | $27.55 |
| CT | — | $12.95 | $27.55 |
| DC | — | $12.88 | $27.55 |
| DE | — | $12.88 | $27.55 |
| FL | — | $13.24 | $27.55 |
| GA | — | $13.24 | $27.55 |
| HI | — | $27.22 | — |
| IA | — | $12.25 | $27.22 |
| ID | — | $12.97 | $27.22 |
| IL | — | $12.72 | $27.55 |
| IN | — | $12.72 | $27.55 |
| KS | — | $12.25 | $27.22 |
| KY | — | $13.24 | $27.55 |
| LA | — | $13.24 | $27.55 |
| MA | — | $12.95 | $27.55 |
| MD | — | $12.88 | $27.55 |
| ME | — | $12.95 | $27.55 |
| MI | — | $12.72 | $27.55 |
| MN | — | $12.25 | $27.55 |
| MO | — | $12.25 | $27.55 |
| MS | — | $13.24 | $27.55 |
| MT | — | $12.97 | $27.22 |
| NC | — | $13.24 | $27.55 |
| ND | — | $12.25 | $27.22 |
| NE | — | $12.25 | $27.22 |
| NH | — | $12.95 | $27.55 |
| NJ | — | $12.88 | $27.55 |
| NM | — | $12.84 | $27.55 |
| NV | — | $11.40 | $27.22 |
| NY | — | $12.88 | $27.55 |
| OH | — | $12.72 | $27.55 |
| OK | — | $12.84 | $27.55 |
| OR | — | $11.40 | $27.22 |
| PA | — | $12.88 | $27.55 |
| PR | — | $31.64 | — |
| RI | — | $12.95 | $27.55 |
| SC | — | $13.24 | $27.55 |
| SD | — | $12.25 | $27.22 |
| TN | — | $13.24 | $27.55 |
| TX | — | $12.84 | $27.55 |
| UT | — | $12.97 | $27.55 |
| VA | — | $13.24 | $27.55 |
| VI | — | $27.55 | — |
| VT | — | $12.95 | $27.55 |
| WA | — | $11.40 | $27.55 |
| WI | — | $12.72 | $27.55 |
| WV | — | $13.24 | $27.55 |
| WY | — | $12.97 | $27.22 |
How the A4595 fee compares
| Measure | Value |
|---|---|
| Rank among 14 A45 codes (lowest = 1) | 6 |
| Family fee range (average of state fees) | $0.13–$1,672.60 |
| Rural fee uplift | 97.1% |
Who bills A4595 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 204 |
| Referring clinicians | 944 |
| Medicare beneficiaries | 1,928 |
| States with claims | 35 |
| Share of services in top 3 states (Ohio, California, Pennsylvania) | 57% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 217 | 1,706 |
| 2023 | 205 | 1,587 |
| 2024 | 204 | 1,928 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A4595, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 15,965 | 1,706 | $18.20 | $13.35 |
| 2023 | 12,731 | 1,587 | $19.60 | $14.42 |
| 2024 | 14,728 | 1,928 | $13.83 | $10.25 |
States with the most A4595 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Ohio | 3,071 | $11.24 |
| California | 2,849 | $9.55 |
| Pennsylvania | 2,422 | $9.57 |
| New Jersey | 1,623 | $9.44 |
| New York | 933 | $10.21 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 6 | Code Descriptor / CPT Instruction |
| outpatient hospital claims | 2 | Nature of Equipment |
Medicare policy articles for this code
- A52520: Transcutaneous Electrical Nerve Stimulators (TENS) - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
- A52713: Transcutaneous Electrical Joint Stimulation Devices (TEJSD) - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
What changed for A4595
- 2026-01-01: Average state fee rose 2.6%: $13.58 to $13.94
- 1996-01-01: A4595 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 A4595?
A4595 is the HCPCS Level II code for electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes). Short descriptor: "Tens suppl 2 lead per month".
How much does Medicare pay for A4595?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $11.40–$31.64. Rural fees can be higher.
Does Medicare cover A4595?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Did the Medicare fee for A4595 change in 2026?
The average non-rural state fee moved from $13.58 in 2025 to $13.94 in 2026 (+2.6%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of A4595 can be billed per day?
6 on DME suppliers; 2 on outpatient hospital claims (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
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under A4595
- Watch A4595 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A4595
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.