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HCPCS T4529 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.

Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each
Key FactDetail
Service Type

National Codes Established for State Medicaid Agencies

Incontinence Supplies

Common Place of Service

None

99 - Other POS

Complexity LevelLow
Medicaid Fee ScheduleView Medicaid rates for T4529

National average reimbursement for HCPCS T4529 by major payers:

bcbs

$0.56

uhc

$0.50

aetna

$0.15

cigna

$14.01

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HCPCS T4529

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HCPCS T4529 vs. Other Incontinence Supplies Codes

The HCPCS T4529 code is part of the National Codes Established for State Medicaid Agencies services used for Incontinence 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 T4529 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.

CodeComplexityDescription
T4528-HCPCSLowAdult sized disposable incontinence product, protective underwear/pull-on, extra large size, each
T4529-HCPCSLowPediatric sized disposable incontinence product, brief/diaper, small/medium size, each
T4530-HCPCSLowPediatric sized disposable incontinence product, brief/diaper, large size, each

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS T4529. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the T4529 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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