HCPCS A4422 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 • Ostomy Pouches and Supplies |
| Complexity Level | Low |
National average reimbursement for HCPCS A4422 by major payers:
$0.13
$0.09
$0.11
$0.39
| 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 A4422 | ||||||
United | A4422 | $0.07 | 1063490845 - KEVIN SCHLESSEL | 311425166 | OH | Rheumatology Physician (207RR0500X) |
United | A4422 | $0.29 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | A4422 | $0.29 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | A4422 | $0.07 | 1306896253 - HOSPITAL AUTHORITY OF VALDOSTA AND LOWNDES COUNTY GEORGIA, SOUTH GEORGIA MEDICAL CENTER | 586004467 - (GA) HOSPITAL AUTHORITY OF VALDOSTA AND LOWNDES COUNTY GEORGIA | GA | General Acute Care Hospital (282N00000X) |
United | A4422 | $0.07 | 1841651056 - KAMRAN RAJAEE | 273818647 | GA | General Acute Care Hospital (282N00000X) |
United | A4422 | $0.12 | 1306136551 - UJUKA ILOABUCHI | 881014763 | GA | Women's Hospital (282NW0100X) |
United | A4422 | $0.07 | 1356552350 - REDMOND PARK HOSPITAL LLC, REDMOND HOSPITAL BASED SERVICES LLC | 201017054 - (GA) REDMOND PARK HOSPITAL LLC | GA | General Acute Care Hospital (282N00000X) |
United | A4422 | $0.07 | 1700830247 - HOSPITAL AUTHORITY OF MITCHELL COUNTY, MITCHELL COUNTY HOSPITAL | 586001307 - (GA) HOSPITAL AUTHORITY OF MITCHELL COUNTY | GA | Critical Access Hospital (282NC0060X) |
United | A4422 | $0.07 | 1508900101 - MICHAEL KOCH | 208418894 - (GA) PATHOLOGY LAB OF GEORGIA LLC | GA | General Acute Care Hospital (282N00000X) |
United | A4422 | $0.10 | 1083711691 - TY COBB HEALTHCARE SYSTEM, COBB MEMORIAL HOSPITAL | 580633978 - (GA) COMMUNITY SERVICES GROUP INC | GA | Rural Acute Care Hospital (282NR1301X) |
United | A4422 | $0.07 | 1497064679 - JENKINS COUNTY HOSPITAL LLC, OPTIM MEDICAL CENTER - JENKINS | 273100894 | GA | Critical Access Hospital (282NC0060X) |
United | A4422 | $0.07 | 1710992433 - HOSPITAL AUTHORITY OF JEFFERSON COUNTY AND THE CITY OF LOUISVILLE, JEFFERSON HOSPITAL | 581309961 - (GA) HOSPITAL AUTHORITY OF JEFFERSON COUNTY AND THE CITY OF LOUISVILLE | GA | General Acute Care Hospital (282N00000X) |
United | A4422 | $0.07 | 1972731800 - MERIWETHER HEALTHCARE, L.L.C., WARM SPRINGS MEDICAL CENTER | 870764535 - (GA) MERIWETHER HEALTHCARE, LLC D/B/A WARM SPRINGS MEDICAL CENTER | GA | Critical Access Hospital (282NC0060X) |
United | A4422 | $0.10 | 1689744450 - ARTHUR M. BLANK HOSPITAL, INC., ARTHUR M. BLANK HOSPITAL | 582147112 - (GA) CHILDRENS HEALTHCARE OF ATLANTA INC | GA | Children's Hospital (282NC2000X) |
United | A4422 | $0.07 | 1730110826 - EVANS MEMORIAL HOSPITAL, INC. | 582257925 - (GA) EVANS MEMORIAL HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
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 A4422 vs. Other Ostomy Pouches and Supplies Codes
The HCPCS A4422 code is part of the Medical And Surgical Supplies services used for Ostomy Pouches and 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 A4422 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 |
|---|---|---|
| A4421-HCPCS | Moderate | Ostomy supply; miscellaneous |
| A4422-HCPCS | Low | Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each |
| A4423-HCPCS | Low | Ostomy pouch, closed; for use on barrier with locking flange, with filter (2-piece), each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A4422. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A4422 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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