A7031 HCPCS code: Face mask interface, replacement for full face mask, each
A7031 is the HCPCS Level II code for face mask interface, replacement for full face mask, each. The 2026 Medicare DMEPOS fee schedule pays $41.70 to $74.80 (NU, new equipment, purchased) 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 3 per day on DME suppliers. Medicare volume rose 11% from 2022 to 2024 (4,730,658 to 5,234,511 services). In 2024, 4,298 suppliers billed Medicare for A7031 (purchases), serving 800,214 beneficiaries; Florida, Texas, California accounted for 20% of services. Its average fee ranks 28 of 37 A70 codes billed NU (family range $0.71–$172.96); rural fees run 49% higher.
Code details
| Field | Value |
|---|---|
| Section | A codes — Transportation, medical/surgical supplies and miscellaneous |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 32 — DMEPOS: inexpensive or routinely purchased item |
| BETOS category | D1E — Other durable medical equipment |
| Added | 2003-01-01 |
| Last action effective | 2003-01-01 |
2026 Medicare DMEPOS fee schedule for A7031
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| NU | new equipment, purchased | $41.70 | $74.80 | — | — |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | NU | $66.25 | — |
| AL | NU | $42.87 | $66.42 |
| AR | NU | $42.87 | $66.42 |
| AZ | NU | $41.70 | $66.42 |
| CA | NU | $42.16 | $66.42 |
| CO | NU | $43.03 | $66.42 |
| CT | NU | $43.57 | $66.42 |
| DC | NU | $41.96 | $66.42 |
| DE | NU | $41.96 | $66.42 |
| FL | NU | $42.87 | $66.42 |
| GA | NU | $42.87 | $66.42 |
| HI | NU | $66.25 | — |
| IA | NU | $42.33 | $66.42 |
| ID | NU | $43.03 | $66.42 |
| IL | NU | $41.91 | $66.42 |
| IN | NU | $41.91 | $66.42 |
| KS | NU | $42.33 | $66.42 |
| KY | NU | $42.87 | $66.42 |
| LA | NU | $42.87 | $66.42 |
| MA | NU | $43.57 | $66.42 |
| MD | NU | $41.96 | $66.42 |
| ME | NU | $43.57 | $66.42 |
| MI | NU | $41.91 | $66.42 |
| MN | NU | $42.33 | $66.42 |
| MO | NU | $42.33 | $66.42 |
| MS | NU | $42.87 | $66.42 |
| MT | NU | $43.03 | $66.42 |
| NC | NU | $42.87 | $66.42 |
| ND | NU | $42.33 | $66.42 |
| NE | NU | $42.33 | $66.42 |
| NH | NU | $43.57 | $66.42 |
| NJ | NU | $41.96 | $66.42 |
| NM | NU | $41.70 | $66.42 |
| NV | NU | $42.16 | $66.42 |
| NY | NU | $41.96 | $66.42 |
| OH | NU | $41.91 | $66.42 |
| OK | NU | $41.70 | $66.42 |
| OR | NU | $42.16 | $66.42 |
| PA | NU | $41.96 | $66.42 |
| PR | NU | $74.80 | — |
| RI | NU | $43.57 | $66.42 |
| SC | NU | $42.87 | $66.42 |
| SD | NU | $42.33 | $66.42 |
| TN | NU | $42.87 | $66.42 |
| TX | NU | $41.70 | $66.42 |
| UT | NU | $43.03 | $66.42 |
| VA | NU | $42.87 | $66.42 |
| VI | NU | $66.25 | — |
| VT | NU | $43.57 | $66.42 |
| WA | NU | $42.16 | $66.42 |
| WI | NU | $41.91 | $66.42 |
| WV | NU | $42.87 | $66.42 |
| WY | NU | $43.03 | $66.42 |
How the A7031 fee compares
| Measure | Value |
|---|---|
| Rank among 37 A70 codes billed NU (lowest = 1) | 28 |
| Family fee range (average of state fees) | $0.71–$172.96 |
| Rural fee uplift | 49.3% |
Who bills A7031 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 4,298 |
| Referring clinicians | 110,680 |
| Medicare beneficiaries | 800,214 |
| States with claims | 58 |
| Share of services in top 3 states (Florida, Texas, California) | 20% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 4,407 | 762,685 |
| 2023 | 4,356 | 786,235 |
| 2024 | 4,298 | 800,214 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A7031, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 4,730,658 | 762,685 | $43.58 | $32.49 |
| 2023 | 4,983,572 | 786,235 | $47.01 | $35.17 |
| 2024 | 5,234,511 | 800,214 | $45.69 | $34.11 |
States with the most A7031 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 354,901 | $32.46 |
| Texas | 354,371 | $33.27 |
| California | 314,977 | $32.05 |
| Illinois | 239,201 | $33.69 |
| Pennsylvania | 231,276 | $32.45 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 3 | Published Contractor Policy |
Medicare policy articles for this code
- A52467: Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
- A52517: Respiratory Assist Devices - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
Covered diagnoses (1 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| G47.33 | Obstructive sleep apnea (adult) (pediatric) | 1 |
What changed for A7031
- 2026-01-01: Average state fee (NU) rose 2.6%: $43.34 to $44.48
- 2003-01-01: A7031 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 A7031?
A7031 is the HCPCS Level II code for face mask interface, replacement for full face mask, each. Short descriptor: "Replacement facemask interfa".
How much does Medicare pay for A7031?
Under the 2026 DMEPOS fee schedule, non-rural state fees are NU (new equipment, purchased): $41.70–$74.80. Rural fees can be higher.
Does Medicare cover A7031?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for A7031?
Medicare policy articles that cite A7031 list 1 covered ICD-10-CM diagnosis codes across 2 articles. The most cited include G47.33 (Obstructive sleep apnea (adult) (pediatric)). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
Did the Medicare fee for A7031 change in 2026?
The average non-rural state fee for NU moved from $43.34 in 2025 to $44.48 in 2026 (+2.6%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of A7031 can be billed per day?
3 on DME suppliers (NCCI medically unlikely edits).
Related A70 codes
- A7000 — Canister, disposable, used with suction pump, each ($9.24–$13.39)
- A7001 — Canister, non-disposable, used with suction pump, each ($40.06–$47.58)
- A7002 — Tubing, used with suction pump, each ($3.87–$5.47)
- A7003 — Administration set, with small volume nonfiltered pneumatic nebulizer, disposable ($1.86–$3.26)
- A7004 — Small volume nonfiltered pneumatic nebulizer, disposable ($1.51–$2.08)
- A7005 — Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable ($11.77–$29.20)
- A7006 — Administration set, with small volume filtered pneumatic nebulizer ($8.19–$14.94)
- A7007 — Large volume nebulizer, disposable, unfilled, used with aerosol compressor ($3.47–$5.87)
- A7008 — Large volume nebulizer, disposable, prefilled, used with aerosol compressor ($12.46–$18.09)
- A7009 — Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer ($54.00–$66.77)
- A7010 — Corrugated tubing, disposable, used with large volume nebulizer, 100 feet ($17.61–$27.19)
- A7011 — Corrugated tubing, non-disposable, used with large volume nebulizer, 10 feet
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 A7031
- Watch A7031 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A7031
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.