HCPCS Level II › A codes A4211 Supp for self-adm injectionsSupplies for self-administered injections
Medicare coverage: Special coverage instructions apply Status: active (October 2026 file) Medically Unlikely Edits (effective October 1, 2026) Practitioner: max 0 units per day (clinical), rationale: CMS Policy Outpatient hospital: max 1 units per day (clinical), rationale: Clinical: CMS Workgroup DME supplier: max 0 units per day (clinical), rationale: CMS Policy Medicare pricing for A4211 Physician Fee Schedule (CY 2026, RVU26D) Status P: bundled or excluded, no separate PFS payment.
Payer policies and prior authorization for A4211 Payer coverage policies that name A4211 A4211 appears in 2 coverage policies from Aetna, Centene.
Payer Policy Role in policy Reviewed Document Aetna Diabetes Tests, Programs and Supplies (0070) covered if criteria are met Feb 20, 2026 payer document Centene Insulin Delivery Systems (V-Go, Omnipod, InPen) (CP.PHAR.534) covered if criteria are met May 1, 2026 payer document
Medicaid fee-for-service Prior authorization required or conditional in NY, OH.
CO: $10.75 (health_first_colorado), effective Jul 1, 2026 IN: $0.31 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2026 TX: $2.04 (dmepos_tos_9_e_j_l_and_r, Home Health Dme, non-facility), effective Apr 1, 2017 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), effective Apr 1, 2026 From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.