Q4431 HCPCS code: Pma skin substitute product, not otherwise specified (list in addition to primary procedure)
Q4431 is the HCPCS Level II code for pma skin substitute product, not otherwise specified (list in addition to primary procedure). Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case.
Code details
| Field | Value |
|---|---|
| Section | Q codes — Temporary codes |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 13 |
| BETOS category | O1E — Other drugs |
| Added | 2026-01-01 |
| Last action effective | 2026-01-01 |
Medicare policy articles for this code
- A59764: Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound (First Coast Service Options, Inc. (MAC - Part A, MAC - Part B))
- A59766: Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B))
What changed for Q4431
- January 2026: Code appears in this HCPCS release
- 2026-01-01: Q4431 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 Q4431?
Q4431 is the HCPCS Level II code for pma skin substitute product, not otherwise specified (list in addition to primary procedure). Short descriptor: "Pma skin substitute, nos".
Does Medicare cover Q4431?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Related Q44 codes
- Q4400 — Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4401 — Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4402 — Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4403 — Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4404 — Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4405 — Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4406 — Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4407 — Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4408 — Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4409 — Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4410 — Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4411 — Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)
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Next steps
- Run a reimbursement report for a device billed under Q4431
- Watch Q4431 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q4431
Sources: CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule; 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.