A7038 HCPCS code: Filter, disposable, used with positive airway pressure device
A7038 is the HCPCS Level II code for filter, disposable, used with positive airway pressure device. The 2026 Medicare DMEPOS fee schedule pays $2.55 to $5.23 (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 6 per day on DME suppliers. Medicare volume rose 9% from 2022 to 2024 (21,245,429 to 23,201,087 services). In 2024, 4,523 suppliers billed Medicare for A7038 (purchases), serving 1,781,845 beneficiaries; Florida, California, Texas accounted for 22% of services. Its average fee ranks 5 of 37 A70 codes billed NU (family range $0.71–$172.96); rural fees run 67% 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 A7038
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| NU | new equipment, purchased | $2.55 | $5.23 | — | — |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | NU | $3.31 | — |
| AL | NU | $2.58 | $4.78 |
| AR | NU | $2.58 | $4.78 |
| AZ | NU | $2.63 | $4.78 |
| CA | NU | $2.59 | $4.78 |
| CO | NU | $2.67 | $4.78 |
| CT | NU | $2.84 | $4.28 |
| DC | NU | $2.64 | $4.28 |
| DE | NU | $2.64 | $4.28 |
| FL | NU | $2.58 | $4.61 |
| GA | NU | $2.58 | $4.75 |
| HI | NU | $3.43 | — |
| IA | NU | $2.55 | $4.78 |
| ID | NU | $2.67 | $4.78 |
| IL | NU | $2.60 | $4.28 |
| IN | NU | $2.60 | $4.28 |
| KS | NU | $2.55 | $4.78 |
| KY | NU | $2.58 | $4.78 |
| LA | NU | $2.58 | $4.78 |
| MA | NU | $2.84 | $4.28 |
| MD | NU | $2.64 | $4.28 |
| ME | NU | $2.84 | $4.28 |
| MI | NU | $2.60 | $4.28 |
| MN | NU | $2.55 | $4.28 |
| MO | NU | $2.55 | $4.78 |
| MS | NU | $2.58 | $4.78 |
| MT | NU | $2.67 | $4.78 |
| NC | NU | $2.58 | $4.73 |
| ND | NU | $2.55 | $4.78 |
| NE | NU | $2.55 | $4.78 |
| NH | NU | $2.84 | $4.28 |
| NJ | NU | $2.64 | $4.28 |
| NM | NU | $2.63 | $4.78 |
| NV | NU | $2.59 | $4.78 |
| NY | NU | $2.64 | $4.28 |
| OH | NU | $2.60 | $4.28 |
| OK | NU | $2.63 | $4.78 |
| OR | NU | $2.59 | $4.78 |
| PA | NU | $2.64 | $4.28 |
| PR | NU | $5.23 | — |
| RI | NU | $2.84 | $4.28 |
| SC | NU | $2.58 | $4.78 |
| SD | NU | $2.55 | $4.78 |
| TN | NU | $2.58 | $4.78 |
| TX | NU | $2.63 | $4.61 |
| UT | NU | $2.67 | $4.78 |
| VA | NU | $2.58 | $4.28 |
| VI | NU | $4.26 | — |
| VT | NU | $2.84 | $4.28 |
| WA | NU | $2.59 | $4.78 |
| WI | NU | $2.60 | $4.28 |
| WV | NU | $2.58 | $4.28 |
| WY | NU | $2.67 | $4.78 |
How the A7038 fee compares
| Measure | Value |
|---|---|
| Rank among 37 A70 codes billed NU (lowest = 1) | 5 |
| Family fee range (average of state fees) | $0.71–$172.96 |
| Rural fee uplift | 66.8% |
Who bills A7038 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 4,523 |
| Referring clinicians | 155,632 |
| Medicare beneficiaries | 1,781,845 |
| States with claims | 59 |
| Share of services in top 3 states (Florida, California, Texas) | 22% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 4,660 | 1,730,195 |
| 2023 | 4,608 | 1,766,442 |
| 2024 | 4,523 | 1,781,845 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A7038, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 21,245,429 | 1,730,195 | $2.80 | $2.07 |
| 2023 | 22,335,207 | 1,766,442 | $3.01 | $2.25 |
| 2024 | 23,201,087 | 1,781,845 | $2.88 | $2.14 |
States with the most A7038 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 1,760,051 | $1.97 |
| California | 1,728,168 | $1.97 |
| Texas | 1,563,519 | $2.14 |
| Pennsylvania | 988,035 | $2.01 |
| Illinois | 968,770 | $2.06 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 6 | Published Contractor Policy |
What changed for A7038
- 2026-01-01: Average state fee (NU) rose 2.7%: $2.67 to $2.74
- 2003-01-01: A7038 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 A7038?
A7038 is the HCPCS Level II code for filter, disposable, used with positive airway pressure device. Short descriptor: "Pos airway pressure filter".
How much does Medicare pay for A7038?
Under the 2026 DMEPOS fee schedule, non-rural state fees are NU (new equipment, purchased): $2.55–$5.23. Rural fees can be higher.
Does Medicare cover A7038?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for A7038 change in 2026?
The average non-rural state fee for NU moved from $2.67 in 2025 to $2.74 in 2026 (+2.7%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of A7038 can be billed per day?
6 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 A7038
- Watch A7038 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A7038
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.