A4614 HCPCS code: Peak expiratory flow rate meter, hand held
A4614 is the HCPCS Level II code for peak expiratory flow rate meter, hand held. The 2026 Medicare DMEPOS fee schedule pays $33.89 to $40.68 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. Medicare volume fell 32% from 2022 to 2024 (179 to 122 services). In 2024, 64 suppliers billed Medicare for A4614 (purchases), serving 122 beneficiaries. Its average fee ranks 9 of 10 A46 codes (family range $0.08–$71.71).
Code details
| Field | Value |
|---|---|
| Section | A codes — Transportation, medical/surgical supplies and miscellaneous |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 46 — Priced by the Medicare contractor (no national fee) |
| BETOS category | Z2 |
| Added | 1999-01-01 |
| Last action effective | 1999-01-01 |
2026 Medicare DMEPOS fee schedule for A4614
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $33.89 | $40.68 | $33.89 | $28.81 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $33.89 | — |
| AL | — | $33.89 | — |
| AR | — | $33.89 | — |
| AZ | — | $33.89 | — |
| CA | — | $33.89 | — |
| CO | — | $33.89 | — |
| CT | — | $33.89 | — |
| DC | — | $33.89 | — |
| DE | — | $33.89 | — |
| FL | — | $33.89 | — |
| GA | — | $33.89 | — |
| HI | — | $33.89 | — |
| IA | — | $33.89 | — |
| ID | — | $33.89 | — |
| IL | — | $33.89 | — |
| IN | — | $33.89 | — |
| KS | — | $33.89 | — |
| KY | — | $33.89 | — |
| LA | — | $33.89 | — |
| MA | — | $33.89 | — |
| MD | — | $33.89 | — |
| ME | — | $33.89 | — |
| MI | — | $33.89 | — |
| MN | — | $33.89 | — |
| MO | — | $33.89 | — |
| MS | — | $33.89 | — |
| MT | — | $33.89 | — |
| NC | — | $33.89 | — |
| ND | — | $33.89 | — |
| NE | — | $33.89 | — |
| NH | — | $33.89 | — |
| NJ | — | $33.89 | — |
| NM | — | $33.89 | — |
| NV | — | $33.89 | — |
| NY | — | $33.89 | — |
| OH | — | $33.89 | — |
| OK | — | $33.89 | — |
| OR | — | $33.89 | — |
| PA | — | $33.89 | — |
| PR | — | $40.68 | — |
| RI | — | $33.89 | — |
| SC | — | $33.89 | — |
| SD | — | $33.89 | — |
| TN | — | $33.89 | — |
| TX | — | $33.89 | — |
| UT | — | $33.89 | — |
| VA | — | $33.89 | — |
| VI | — | $33.89 | — |
| VT | — | $33.89 | — |
| WA | — | $33.89 | — |
| WI | — | $33.89 | — |
| WV | — | $33.89 | — |
| WY | — | $33.89 | — |
How the A4614 fee compares
| Measure | Value |
|---|---|
| Rank among 10 A46 codes (lowest = 1) | 9 |
| Family fee range (average of state fees) | $0.08–$71.71 |
| Rural fee uplift | — |
Who bills A4614 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 64 |
| Referring clinicians | 87 |
| Medicare beneficiaries | 122 |
| States with claims | 1 |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 97 | 178 |
| 2023 | 86 | 151 |
| 2024 | 64 | 122 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A4614, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 179 | 178 | $28.16 | $20.85 |
| 2023 | 151 | 151 | $29.39 | $21.64 |
| 2024 | 122 | 122 | $31.29 | $23.59 |
States with the most A4614 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Maryland | 39 | $24.41 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 1 | Code Descriptor / CPT Instruction |
| outpatient hospital claims | 1 | Code Descriptor / CPT Instruction |
What changed for A4614
- 2026-01-01: Average state fee rose 2.0%: $33.36 to $34.02
- 1999-01-01: A4614 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 A4614?
A4614 is the HCPCS Level II code for peak expiratory flow rate meter, hand held. Short descriptor: "Hand-held pefr meter".
How much does Medicare pay for A4614?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $33.89–$40.68. Rural fees can be higher.
Does Medicare cover A4614?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for A4614 change in 2026?
The average non-rural state fee moved from $33.36 in 2025 to $34.02 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of A4614 can be billed per day?
1 on DME suppliers; 1 on outpatient hospital claims (NCCI medically unlikely edits).
Related A46 codes
- A4600 — Sleeve for intermittent limb compression device, replacement only, each
- A4601 — Lithium ion battery, rechargeable, for non-prosthetic use, replacement
- A4602 — Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each ($5.31–$6.33)
- A4604 — Tubing with integrated heating element for use with positive airway pressure device ($49.31–$76.79)
- A4605 — Tracheal suction catheter, closed system, each ($23.31–$27.99)
- A4606 — Oxygen probe for use with oximeter device, replacement
- A4608 — Transtracheal oxygen catheter, each ($71.44–$85.73)
- A4611 — Battery, heavy duty; replacement for patient owned ventilator
- A4612 — Battery cables; replacement for patient-owned ventilator
- A4613 — Battery charger; replacement for patient-owned ventilator
- A4615 — Cannula, nasal ($1.04–$1.25)
- A4616 — Tubing (oxygen), per foot ($0.08–$0.10)
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 A4614
- Watch A4614 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A4614
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.