HCPCS A4221 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Medical And Surgical Supplies • Injection and Infusion Supplies |
| Complexity Level | Low |
National average reimbursement for HCPCS A4221 by major payers:
$21.24
$15.61
$18.35
$30.14
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS A4221 | ||||||
United | A4221 | $13.33 | 1023342532 - ABILENE KIDNEY CLINIC, P.A. | 270962460 - ABILENE KIDNEY CLINIC, P.A. | TX | Nephrology Physician (207RN0300X) |
United | A4221 | $10.96 | 1538737275 - DFW FAMILY CLINIC | 863692901 - DFW FAMILY CLINIC | TX | Family Medicine Physician (207Q00000X) |
United | A4221 | $21.65 | 1477871184 - DAVID GREENBERG | 756002868 | TX | Infectious Disease Physician (207RI0200X) |
United | A4221 | $15.17 | 1790478444 - INTENSIVIST MEDICINE SERVICES OF TX, PC | 923083345 - INTENSIVIST MEDICINE SERVICES OF TX PC | TX | Critical Care Medicine (Internal Medicine) Physician (207RC0200X) |
United | A4221 | $13.15 | 1336267871 - MADHURI SOPIRALA | 756002868 | TX | Infectious Disease Physician (207RI0200X) |
United | A4221 | $10.96 | 1902485618 - MIND-BODY HEALTH COACHING OF NORTH TEXAS | 853220670 - MINDBODY HEALTH COACHING OF NORTH TEXAS | TX | Multi-Specialty Group (193200000X) |
United | A4221 | $21.65 | 1295027910 - RAWN BOSLEY | 752286998 - DALLAS ASSOCIATED DERMATOLOGISTS, PLLC | TX | Dermatology Physician (207N00000X) |
United | A4221 | $21.65 | 1124250410 - CENTRAL TEXAS MEDICAL SPECIALISTS PLLC | 460829574 - CENTRAL TEXAS MEDICAL SPECIALISTS, PLLC | TX | Multi-Specialty Group (193200000X) |
United | A4221 | $21.65 | 1245686609 - MEGAN TRAINOR | 10690116 - SUSAN E. DOZIER, M.D., P.A. | TX | Dermatology Physician (207N00000X) |
United | A4221 | $10.96 | 1922648310 - CEDAR CREEK WELLNESS GROUP | 844266300 - CEDAR CREEK WELLNESS GROUP | TX | Psychiatric/Mental Health Nurse Practitioner (363LP0808X) |
United | A4221 | $11.83 | 1699943191 - HIGH COUNTRY COMMUNITY RURAL HEALTH CLINIC | 751702162 | TX | Medical Physician Assistant (363AM0700X) |
United | A4221 | $21.65 | 1508052036 - DONALD GLASS | 756002868 | TX | Dermatology Physician (207N00000X) |
United | A4221 | $13.15 | 1437437860 - ABBY LAU | 756002868 | TX | Infectious Disease Physician (207RI0200X) |
United | A4221 | $22.03 | 1134652993 - FRANK WINSETT | 760010407 | TX | Single Specialty Group (193400000X) |
United | A4221 | $10.96 | 1861426934 - M & M NORTH, LLP | 20776970 - M M NORTH LLP | TX | Family Medicine Physician (207Q00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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HCPCS A4221 vs. Other Injection and Infusion Supplies Codes
The HCPCS A4221 code is part of the Medical And Surgical Supplies services used for Injection and Infusion Supplies. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS A4221 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| A4220-HCPCS | Low | Refill kit for implantable infusion pump |
| A4221-HCPCS | Low | Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
| A4222-HCPCS | Low | Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A4221. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A4221 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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