HCPCS code A4238 — Adju cgm supply allowance. Status: Active. Effective Jan 1, 2023. Source: CMS HCPCS Level II.

A4238

Active

Adju cgm supply allowance

Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service

Category: Transportation & Supplies
Section: A-codes: Transportation, Medical & Surgical Supplies
Effective: Jan 1, 2023
Code type: alphanumeric
OPPS Status: Y — Non-implantable durable medical equipment

MUE — Medically Unlikely Edits

Maximum units of A4238 Medicare will pay for one beneficiary on one date of service. Claims exceeding the MUE are denied or returned for review.

Service Type Max Units / Day
DME Supplier 3
Outpatient Hospital 3
Practitioner Services 3

Source: CMS Medicare NCCI Medically Unlikely Edits

Change History

Quarterly changes published by CMS. Revisions may affect the code description, coverage, or rate — review each quarter's changes before submitting claims.

  • New Code 2023-Q1
    Adju cgm supply allowance