`A4635` Underarm crutch pad

Underarm pad, crutch, replacement, 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 0 units per day (clinical), rationale: CMS Policy
DME supplier: max 2 units per day (policy), rationale: Code Descriptor / CPT Instruction

Medicare pricing for A4635

DMEPOS fee schedule, July 2026 (DME26-C)

NU (purchased, new), inexpensive or routinely purchased (IN): non-rural $6.19 to $7.28 in the contiguous states; $7.28 to $15.36 in AK, HI, PR and VI; ceiling $7.28, floor $6.19
RR (rental), inexpensive or routinely purchased (IN): non-rural $0.84 to $0.99 in the contiguous states; $0.92 to $1.48 in AK, HI, PR and VI; ceiling $0.99, floor $0.84
UE (purchased, used), inexpensive or routinely purchased (IN): non-rural $4.13 to $4.86 in the contiguous states; $4.85 to $11.51 in AK, HI, PR and VI; ceiling $4.86, floor $4.13

Physician Fee Schedule (CY 2026, RVU26D)

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

Payer policies and prior authorization for A4635

Payer coverage policies that name A4635

A4635 appears in 1 coverage policy from Aetna.

Payer	Policy	Role in policy	Reviewed	Document
Aetna	Ambulatory Assist Devices: Canes, Crutches, and Walkers (0505)	covered if criteria are met	Aug 3, 2026	payer document

Medicaid fee-for-service

Prior authorization required or conditional in LA, MA, OH, VA, WV.

AZ: $7.39 (dme), effective Oct 1, 2026
CO: $4.93 (chp_plus, non-facility), effective Jul 1, 2026
FL: $1.92 (dme), effective Jul 1, 2026
IL: $4.14 (dme), effective Jan 1, 2026
IN: $6.07 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2026
KS: $4.95 (default), effective Jul 1, 2026
KY: $4.89 (dme), effective Jan 1, 2026
LA: $3.66 (dme), effective Jul 1, 2012
MD: $6.19 (dme), effective Apr 1, 2026
MS: $5.82 (comprehensive), effective Jul 1, 2026
ND: $7.00 (dme), effective Aug 1, 2026
NE: $5.68 (dme), effective Jul 1, 2026
NY: $2.86 (dme), effective Jul 1, 2026
OH: $1.50 (dme), effective May 25, 1991
OK: $7.28 (dme), effective Jan 1, 2026
TX: $2.58 (dmepos_tos_9_e_j_l_and_r, Medical Supplier (Dme), non-facility), effective Jan 1, 2003
VA: $6.55 (dme), effective Dec 1, 2026
VT: $5.19 (outpatient_hospital_opps), effective Feb 1, 2026
WA: $5.48 (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.

A4635 Underarm crutch pad