HCPCS Level II › A codes A4306 Drug delivery system <=50 mlDisposable drug delivery system, flow rate of less than 50 ml per hour
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 2 units per day (clinical), rationale: Clinical: Data DME supplier: max 0 units per day (clinical), rationale: Published Contractor Policy Medicare pricing for A4306 Physician Fee Schedule (CY 2026, RVU26D) Status P: bundled or excluded, no separate PFS payment.
Payer policies and prior authorization for A4306 Payer coverage policies that name A4306 A4306 appears in 2 coverage policies from Aetna.
Payer Policy Role in policy Reviewed Document Aetna Anesthetic and Antiemetic Infusion Pumps (0607) not covered Sep 9, 2026 payer document Aetna Infusion Pumps (0161) covered if criteria are met Mar 31, 2026 payer document
Medicaid fee-for-service Prior authorization required or conditional in CO, LA, NY, OH.
CO: $20.37 (chp_plus, non-facility), effective Jul 1, 2026 IN: $27.45 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2026 LA: $11.16 (dme), effective Sep 1, 2024 MD: $23.10 (dme), effective Apr 1, 2026 OH: $12.73 (dme), effective Apr 1, 2001 OK: $0.00 (outpatient_hospital_apc), effective Jan 1, 2026 TX: $18.33 (dmepos_tos_9_e_j_l_and_r, Medical Supplier (Dme), non-facility), effective Jul 1, 2011 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.