HCPCS Level II › A codes A4215 Sterile needleNeedle, sterile, any size, each
Medicare coverage: Carrier judgment 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 9 units per day (clinical), rationale: Clinical: Data DME supplier: max 0 units per day (clinical), rationale: CMS Policy Medicare pricing for A4215 Physician Fee Schedule (CY 2026, RVU26D) Status X: statutory exclusion, not paid under the PFS.
Payer policies and prior authorization for A4215 Payer coverage policies that name A4215 A4215 appears in 1 coverage policy from Aetna.
Payer Policy Role in policy Reviewed Document Aetna Diabetes Tests, Programs and Supplies (0070) covered if criteria are met Feb 20, 2026 payer document
Medicaid fee-for-service Prior authorization required or conditional in KY, LA, MA, OH, VA, WV.
AZ: $0.02 (outpatient_hospital), effective Oct 1, 2011 CO: $0.32 (health_first_colorado), effective Jul 1, 2026 FL: $0.20 (dme), effective Jul 1, 2026 IN: $0.27 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2026 KS: $0.18 (default), effective Jun 1, 2007 KY: $0.97 (dme), effective Jan 1, 2026 MD: $0.04 (dme), effective Apr 1, 2026 MS: $0.37 (comprehensive), effective Jul 1, 2026 ND: $0.00 (dme), effective Aug 1, 2026 NE: $0.53 (dme), effective Jul 1, 2026 NY: $0.35 (dme), effective Jul 1, 2026 OK: $0.38 (dme), effective Aug 1, 2020 TX: $0.23 (dmepos_tos_9_e_j_l_and_r, Medical Supplier (Dme), non-facility), effective Apr 1, 2019 VA: $0.15 (dme), effective Dec 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $0.33 (medical_equipment_supplies), effective Jul 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.