HCPCS A4259 Fee Schedule

HCPCS A4259 vs. Other Other Supplies Including Diabetes Supplies and Contraceptives Codes

The HCPCS A4259 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 A4259 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.

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A4259. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the A4259 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.