A4238 — Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service
A4238 is a HCPCS Level II code for supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service. It belongs to the Transportation, Medical & Surgical Supplies, Administrative section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusX
Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
Medically Unlikely Edits — units per day
The most units of A4238 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 3 units MAI 3 — Date of Service Edit: Clinical · CMS Policy
- outpatient
- 3 units MAI 3 — Date of Service Edit: Clinical · CMS Policy
- DME supplier
- 3 units MAI 3 — Date of Service Edit: Clinical · CMS Policy
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for A4238
- Long descriptor
- Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service
- Short descriptor
- Adju cgm supply allowance
- Added
- April 1, 2022
- BETOS
- D1E
- Pricing indicator
- 34 — DMEPOS
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
DME supplies. Price subject to floors and ceilings.
Codes adjacent to A4238
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If A4238 is not quite right, the correct code is very often within a few positions of it.
- A4226Supplies for maintenance of insulin infusion pump with dosage rate adjustment using therapeutic continuous glucose sensing, per week
- A4230Infusion set for external insulin pump, non needle cannula type
- A4231Infusion set for external insulin pump, needle type
- A4232Syringe with needle for external insulin pump, sterile, 3 cc
- A4233Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each
- A4234Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each
- A4235Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each
- A4236Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each
- A4239Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service
- A4244Alcohol or peroxide, per pint
- A4245Alcohol wipes, per box
- A4246Betadine or phisohex solution, per pint
- A4247Betadine or iodine swabs/wipes, per box
- A4248Chlorhexidine containing antiseptic, 1 ml
- A4250Urine test or reagent strips or tablets (100 tablets or strips)
- A4252Blood ketone test or reagent strip, each
Questions about A4238
What is HCPCS code A4238?
A4238 is a HCPCS Level II code for supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service. It sits in the Transportation, Medical & Surgical Supplies, Administrative section.
Does Medicare cover A4238?
The CMS HCPCS file marks A4238 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
How is A4238 paid under the physician fee schedule?
A4238 carries PFS status code X. Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.