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See a sample rate comparisonHCPCS A4255 Fee Schedule
Last Verified: September 2026
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.
Platforms for home blood glucose monitor, 50 per box
| Key Fact | Detail |
|---|---|
| Service Type | Medical And Surgical Supplies Other Supplies Including Diabetes Supplies and Contraceptives |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for A4255 |
National average reimbursement for HCPCS A4255 by major payers:
$4.90
$3.00
$3.86
$4.47
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HCPCS A4255
5 of 25 sample ratesHigher to lower in this preview
Emory University, Emory University Hospital
Emory University
$10.48Published ratePiedmont Newton Hospital, Inc., Newton Medical Center
Piedmont Newton Hospital Inc
$6.38Published rateEffingham Hospital, Inc., Effingham Health System
Effingham Hospital Inc
$2.70Published rateJasper Health Services, Inc., Jasper Memorial Hospital
Jasper Health Services Inc
$2.63Published rateBorbas Surgical Supply, Inc
Borbas Surgical Supply Inc
$1.84Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS A4255 vs. Other Other Supplies Including Diabetes Supplies and Contraceptives Codes
The HCPCS A4255 code is part of the Medical And Surgical Supplies services used for Other Supplies Including Diabetes Supplies and Contraceptives. 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 A4255 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 |
|---|---|---|
| A4253-HCPCS | Low | Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
| A4255-HCPCS | Low | Platforms for home blood glucose monitor, 50 per box |
| A4256-HCPCS | Low | Normal, low and high calibrator solution / chips |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A4255. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A4255 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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