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See a sample rate comparisonHCPCS A7031 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.
Face mask interface, replacement for full face mask, each
| Key Fact | Detail |
|---|---|
| Service Type | Medical And Surgical Supplies Breathing Aids |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for A7031 |
National average reimbursement for HCPCS A7031 by major payers:
$44.40
$37.34
$37.82
$50.00
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HCPCS A7031
5 of 25 sample ratesHigher to lower in this preview
Melissa Matthews
Vanderbilt University Medical Center
$25.82Published rateSarah Taylor
Vanderbilt University Medical Center
$25.82Published rateAbigail Leofsky
Vanderbilt University Medical Center
$25.82Published rateAnuj Patel
Vanderbilt University Medical Center
$25.82Published rateDarshini Patel
Vanderbilt University Medical Center
$25.82Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS A7031 vs. Other Breathing Aids Codes
The HCPCS A7031 code is part of the Medical And Surgical Supplies services used for Breathing Aids. 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 A7031 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 |
|---|---|---|
| A7030-HCPCS | Low | Full face mask used with positive airway pressure device, each |
| A7031-HCPCS | Low | Face mask interface, replacement for full face mask, each |
| A7032-HCPCS | Low | Cushion for use on nasal mask interface, replacement only, each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A7031. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A7031 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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