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Fee Schedule Category: Supplies
Short Description for A4556: Electrodes, pair
Long Description for A4556: ELECTRODES, (E.G., APNEA MONITOR), PER PAIR

Rural ZIP Code Checker


Beneficiary State of Residence Modifier Modifier Rural Fee Non-Rural Fee Effective From Effective To
AR $14.86 04/01/2022 06/30/2022
AL $14.86 04/01/2022 06/30/2022
DC $12.63 04/01/2022 06/30/2022
CO $14.86 04/01/2022 06/30/2022
AK $12.34 04/01/2022 06/30/2022
CA $12.63 04/01/2022 06/30/2022
AZ $14.86 04/01/2022 06/30/2022
CT $14.86 04/01/2022 06/30/2022
HI $13.20 04/01/2022 06/30/2022
NV $14.86 04/01/2022 06/30/2022
ID $12.63 04/01/2022 06/30/2022
IA $12.63 04/01/2022 06/30/2022
NM $14.86 04/01/2022 06/30/2022
DE $14.86 04/01/2022 06/30/2022
FL $13.24 04/01/2022 06/30/2022
GA $14.86 04/01/2022 06/30/2022
ME $12.63 04/01/2022 06/30/2022
SD $14.86 04/01/2022 06/30/2022
KY $12.71 04/01/2022 06/30/2022
PA $12.63 04/01/2022 06/30/2022
LA $14.86 04/01/2022 06/30/2022
MD $14.86 04/01/2022 06/30/2022
IL $12.63 04/01/2022 06/30/2022
NC $12.63 04/01/2022 06/30/2022
KS $12.63 04/01/2022 06/30/2022
MT $14.86 04/01/2022 06/30/2022
MA $12.63 04/01/2022 06/30/2022
IN $14.86 04/01/2022 06/30/2022
MI $14.86 04/01/2022 06/30/2022
NE $12.63 04/01/2022 06/30/2022
MS $12.63 04/01/2022 06/30/2022
MO $12.63 04/01/2022 06/30/2022
ND $14.86 04/01/2022 06/30/2022
MN $12.63 04/01/2022 06/30/2022
NH $12.63 04/01/2022 06/30/2022
NJ $14.86 04/01/2022 06/30/2022
OR $14.50 04/01/2022 06/30/2022
NY $14.86 04/01/2022 06/30/2022
VA $14.86 04/01/2022 06/30/2022
OH $14.86 04/01/2022 06/30/2022
OK $14.86 04/01/2022 06/30/2022
WA $12.63 04/01/2022 06/30/2022
TN $12.63 04/01/2022 06/30/2022
VT $12.63 04/01/2022 06/30/2022
PR $8.66 04/01/2022 06/30/2022
VI $14.86 04/01/2022 06/30/2022
RI $14.86 04/01/2022 06/30/2022
UT $12.63 04/01/2022 06/30/2022
TX $14.86 04/01/2022 06/30/2022
SC $12.63 04/01/2022 06/30/2022
WI $14.86 04/01/2022 06/30/2022
WY $14.86 04/01/2022 06/30/2022
WV $12.63 04/01/2022 06/30/2022

Note: A blank cell in the Rural Fee column designates the Rural Fee is the same as the Non-Rural Fee.

Note: This HCPCS code may be subject to a single payment amount (SPA) under the Medicare DMEPOS Competitive Bidding Program. For information on when the SPA applies, specific rates for the SPA, please check the website for the Competitive Bidding Implementation Contractor (CBIC) at https://www.dmecompetitivebid.com.

Note: PDAC provides the CMS quarterly fee schedule amounts directly from the CMS website. If CMS updates the fee schedule within a quarter, DMECS will display the most current fee schedule.