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See a sample rate comparisonHCPCS T4539 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.
Incontinence product, diaper/brief, reusable, any size, each
| Key Fact | Detail |
|---|---|
| Service Type | National Codes Established for State Medicaid Agencies Incontinence Supplies |
| Common Place of Service | None 99 - Other POS |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for T4539 |
National average reimbursement for HCPCS T4539 by major payers:
$6.18
$5.45
$0.58
$8.61
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HCPCS T4539
5 of 25 sample ratesHigher to lower in this preview
Home Medical Specialties, Inc.
Home Medical Specialties Inc
$6.80Published rateMbs Ltd
$6.80Published rateTwin Tier Management Corp Inc
$4.21Published rateHome Medical Equipment, LLC
Home Medical Equipment Ny, Inc.
$0.03Published rateAll Pro Medical Supplies, Inc
All Pro Medical Supplies Inc
$0.03Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS T4539 vs. Other Incontinence Supplies Codes
The HCPCS T4539 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 T4539 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 |
|---|---|---|
| T4538-HCPCS | Low | Diaper service, reusable diaper, each diaper |
| T4539-HCPCS | Low | Incontinence product, diaper/brief, reusable, any size, each |
| T4540-HCPCS | Low | Incontinence product, protective underpad, reusable, chair 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 T4539. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the T4539 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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