`A4337` Incontinent rectal insert

Incontinence supply, rectal insert, any type, each

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 2 units per day (clinical), rationale: Clinical: CMS Workgroup
DME supplier: max 0 units per day (clinical), rationale: Published Contractor Policy

Medicare pricing for A4337

Physician Fee Schedule (CY 2026, RVU26D)

Status X: statutory exclusion, not paid under the PFS.

Payer policies and prior authorization for A4337

Medicaid fee-for-service

Prior authorization required or conditional in IN.

OH: $10.00 (dme), effective Jan 1, 2024
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.

A4337 Incontinent rectal insert