A7038 — Filter, disposable, used with positive airway pressure device
A7038 is a HCPCS Level II code for filter, disposable, used with positive airway pressure device. 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 A7038 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
- 6 units MAI 2 — Date of Service Edit: Policy · Published Contractor 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 A7038
- Long descriptor
- Filter, disposable, used with positive airway pressure device
- Short descriptor
- Pos airway pressure filter
- Added
- January 1, 2003
- BETOS
- D1E
- Pricing indicator
- 32 — 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.
Inexpensive and routinely purchased DME. Price subject to floors and ceilings.
Codes adjacent to A7038
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If A7038 is not quite right, the correct code is very often within a few positions of it.
- A7030Full face mask used with positive airway pressure device, each
- A7031Face mask interface, replacement for full face mask, each
- A7032Cushion for use on nasal mask interface, replacement only, each
- A7033Pillow for use on nasal cannula type interface, replacement only, pair
- A7034Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap
- A7035Headgear used with positive airway pressure device
- A7036Chinstrap used with positive airway pressure device
- A7037Tubing used with positive airway pressure device
- A7039Filter, non disposable, used with positive airway pressure device
- A7040One way chest drain valve
- A7041Water seal drainage container and tubing for use with implanted chest tube
- A7042Implanted pleural catheter, eachterminated
- A7043Vacuum drainage bottle and tubing for use with implanted catheterterminated
- A7044Oral interface used with positive airway pressure device, each
- A7045Exhalation port with or without swivel used with accessories for positive airway devices, replacement only
- A7046Water chamber for humidifier, used with positive airway pressure device, replacement, each
Questions about A7038
What is HCPCS code A7038?
A7038 is a HCPCS Level II code for filter, disposable, used with positive airway pressure device. It sits in the Transportation, Medical & Surgical Supplies, Administrative section.
Does Medicare cover A7038?
The CMS HCPCS file marks A7038 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 A7038 paid under the physician fee schedule?
A7038 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.