A4620 HCPCS code: Variable concentration mask
A4620 is the HCPCS Level II code for variable concentration mask. The 2026 Medicare DMEPOS fee schedule pays $0.86 to $0.99 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 1 per day on outpatient hospital claims. Its average fee ranks 2 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 | D — Special coverage instructions apply |
| Pricing indicator | 00 — Not separately priced by Medicare |
| BETOS category | D1C — Oxygen and supplies |
| Added | 1990-01-01 |
| Last action effective | 2009-01-01 |
2026 Medicare DMEPOS fee schedule for A4620
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $0.86 | $0.99 | $0.91 | $0.77 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $0.86 | — |
| AL | — | $0.91 | — |
| AR | — | $0.91 | — |
| AZ | — | $0.86 | — |
| CA | — | $0.91 | — |
| CO | — | $0.91 | — |
| CT | — | $0.86 | — |
| DC | — | $0.91 | — |
| DE | — | $0.86 | — |
| FL | — | $0.86 | — |
| GA | — | $0.91 | — |
| HI | — | $0.91 | — |
| IA | — | $0.91 | — |
| ID | — | $0.86 | — |
| IL | — | $0.91 | — |
| IN | — | $0.91 | — |
| KS | — | $0.86 | — |
| KY | — | $0.91 | — |
| LA | — | $0.91 | — |
| MA | — | $0.86 | — |
| MD | — | $0.86 | — |
| ME | — | $0.86 | — |
| MI | — | $0.91 | — |
| MN | — | $0.91 | — |
| MO | — | $0.91 | — |
| MS | — | $0.91 | — |
| MT | — | $0.86 | — |
| NC | — | $0.91 | — |
| ND | — | $0.91 | — |
| NE | — | $0.86 | — |
| NH | — | $0.86 | — |
| NJ | — | $0.86 | — |
| NM | — | $0.91 | — |
| NV | — | $0.86 | — |
| NY | — | $0.86 | — |
| OH | — | $0.91 | — |
| OK | — | $0.91 | — |
| OR | — | $0.86 | — |
| PA | — | $0.86 | — |
| PR | — | $0.99 | — |
| RI | — | $0.86 | — |
| SC | — | $0.91 | — |
| SD | — | $0.91 | — |
| TN | — | $0.91 | — |
| TX | — | $0.86 | — |
| UT | — | $0.91 | — |
| VA | — | $0.86 | — |
| VI | — | $0.91 | — |
| VT | — | $0.86 | — |
| WA | — | $0.91 | — |
| WI | — | $0.91 | — |
| WV | — | $0.91 | — |
| WY | — | $0.91 | — |
How the A4620 fee compares
| Measure | Value |
|---|---|
| Rank among 10 A46 codes (lowest = 1) | 2 |
| Family fee range (average of state fees) | $0.08–$71.71 |
| Rural fee uplift | — |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 1 | Clinical: Data |
Medicare policy articles for this code
- A52514: Oxygen and Oxygen Equipment - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
What changed for A4620
- 2026-01-01: Average state fee rose 2.3%: $0.87 to $0.89
- 1990-01-01: A4620 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 A4620?
A4620 is the HCPCS Level II code for variable concentration mask. Short descriptor: "Variable concentration mask".
How much does Medicare pay for A4620?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $0.86–$0.99. Rural fees can be higher.
Does Medicare cover A4620?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Did the Medicare fee for A4620 change in 2026?
The average non-rural state fee moved from $0.87 in 2025 to $0.89 in 2026 (+2.3%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of A4620 can be billed per day?
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
- A4614 — Peak expiratory flow rate meter, hand held ($33.89–$40.68)
- A4615 — Cannula, nasal ($1.04–$1.25)
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Next steps
- Run a reimbursement report for a device billed under A4620
- Watch A4620 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A4620
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.