A4255 — Platforms for home blood glucose monitor, 50 per box
A4255 is a HCPCS Level II code for platforms for home blood glucose monitor, 50 per box. It belongs to the Transportation, Medical & Surgical Supplies, Administrative section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Special coverage instructions apply
There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
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 A4255 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
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- outpatient
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- DME supplier
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · Nature of Equipment
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 A4255
- Long descriptor
- Platforms for home blood glucose monitor, 50 per box
- Short descriptor
- Glucose monitor platforms
- Added
- January 1, 1997
- 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 A4255
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If A4255 is not quite right, the correct code is very often within a few positions of it.
- 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
- A4253Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips
- A4256Normal, low and high calibrator solution / chips
- A4257Replacement lens shield cartridge for use with laser skin piercing device, each
- A4258Spring-powered device for lancet, each
- A4259Lancets, per box of 100
- A4261Cervical cap for contraceptive use
- A4262Temporary, absorbable lacrimal duct implant, each
- A4263Permanent, long term, non-dissolvable lacrimal duct implant, each
- A4264Permanent implantable contraceptive intratubal occlusion device(s) and delivery system
Questions about A4255
What is HCPCS code A4255?
A4255 is a HCPCS Level II code for platforms for home blood glucose monitor, 50 per box. It sits in the Transportation, Medical & Surgical Supplies, Administrative section.
Does Medicare cover A4255?
The CMS HCPCS file marks A4255 as "Special coverage instructions apply". There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
How is A4255 paid under the physician fee schedule?
A4255 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.