T4538 HCPCS code: Diaper service, reusable diaper, each diaper
T4538 is the HCPCS Level II code for diaper service, reusable diaper, each diaper. Its Medicare coverage code is M (Non-covered by Medicare): Medicare does not cover this item or service.
Code details
| Field | Value |
|---|---|
| Section | T codes — National codes established for state Medicaid agencies |
| Coverage code | M — Non-covered by Medicare |
| Pricing indicator | 00 — Not separately priced by Medicare |
| BETOS category | D1A — Medical/surgical supplies |
| Added | 2005-01-01 |
| Last action effective | 2005-01-01 |
What changed for T4538
- 2005-01-01: T4538 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 T4538?
T4538 is the HCPCS Level II code for diaper service, reusable diaper, each diaper. Short descriptor: "Diaper serv reusable diaper".
Does Medicare cover T4538?
Coverage code M — Non-covered by Medicare. Medicare does not cover this item or service.
Related T45 codes
- T4521 — Adult sized disposable incontinence product, brief/diaper, small, each
- T4522 — Adult sized disposable incontinence product, brief/diaper, medium, each
- T4523 — Adult sized disposable incontinence product, brief/diaper, large, each
- T4524 — Adult sized disposable incontinence product, brief/diaper, extra large, each
- T4525 — Adult sized disposable incontinence product, protective underwear/pull-on, small size, each
- T4526 — Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each
- T4527 — Adult sized disposable incontinence product, protective underwear/pull-on, large size, each
- T4528 — Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each
- T4529 — Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each
- T4530 — Pediatric sized disposable incontinence product, brief/diaper, large size, each
- T4531 — Pediatric sized disposable incontinence product, protective underwear/pull-on, small/medium size, each
- T4532 — Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each
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Next steps
- Run a reimbursement report for a device billed under T4538
- Watch T4538 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for T4538
Sources: CMS HCPCS Level II release October 2025; 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.