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See a sample rate comparisonHCPCS A4259 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.
Lancets, per box of 100
| 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 A4259 |
National average reimbursement for HCPCS A4259 by major payers:
$3.45
$4.33
$2.41
$1.51
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HCPCS A4259
5 of 25 sample ratesHigher to lower in this preview
Twin Tier Management Corp Inc, Dba Med Supply Depot
Twin Tier Management Corp Inc
$9.27Published rateLiberty Orthotics, Inc.
Liberty Orthotics Inc
$6.40Published rateA & O Surgical Supply Co, Inc, A & O Surgical Supply Co Inc
A O Surgical Supply Co Inc
$5.69Published rateInnovative Services Inc, Upstate Homecare
Innovative Services, Inc
$1.35Published rateDuane Reade Pharmacy, Duane Reade Pharmacy
Duane Reade
$0.56Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS 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.
| Code | Complexity | Description |
|---|---|---|
| A4258-HCPCS | Low | Spring-powered device for lancet, each |
| A4259-HCPCS | Low | Lancets, per box of 100 |
| A4261-HCPCS | Low | Cervical cap for contraceptive use |
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.
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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