Q4025 — Cast supplies, hip spica (one or both legs), adult (11 years +), plaster
Q4025 is a HCPCS Level II code for cast supplies, hip spica (one or both legs), adult (11 years +), plaster. It belongs to the Temporary Codes 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 Q4025 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
- 1 unit MAI 3 — Date of Service Edit: Clinical · Anatomic Consideration
- outpatient
- 1 unit MAI 3 — Date of Service Edit: Clinical · Anatomic Consideration
- DME supplier
- 0 — never payable 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 Q4025
- Long descriptor
- Cast supplies, hip spica (one or both legs), adult (11 years +), plaster
- Short descriptor
- Cast sup hip spica plaster
- Added
- July 1, 2001
- BETOS
- D1A
- Pricing indicator
- 55 — Other
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.
Splints and casts, effective 1 October 2014.
Codes adjacent to Q4025
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If Q4025 is not quite right, the correct code is very often within a few positions of it.
- Q4017Cast supplies, long arm splint, adult (11 years +), plaster
- Q4018Cast supplies, long arm splint, adult (11 years +), fiberglass
- Q4019Cast supplies, long arm splint, pediatric (0-10 years), plaster
- Q4020Cast supplies, long arm splint, pediatric (0-10 years), fiberglass
- Q4021Cast supplies, short arm splint, adult (11 years +), plaster
- Q4022Cast supplies, short arm splint, adult (11 years +), fiberglass
- Q4023Cast supplies, short arm splint, pediatric (0-10 years), plaster
- Q4024Cast supplies, short arm splint, pediatric (0-10 years), fiberglass
- Q4026Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass
- Q4027Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster
- Q4028Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass
- Q4029Cast supplies, long leg cast, adult (11 years +), plaster
- Q4030Cast supplies, long leg cast, adult (11 years +), fiberglass
- Q4031Cast supplies, long leg cast, pediatric (0-10 years), plaster
- Q4032Cast supplies, long leg cast, pediatric (0-10 years), fiberglass
- Q4033Cast supplies, long leg cylinder cast, adult (11 years +), plaster
Questions about Q4025
What is HCPCS code Q4025?
Q4025 is a HCPCS Level II code for cast supplies, hip spica (one or both legs), adult (11 years +), plaster. It sits in the Temporary Codes section.
Does Medicare cover Q4025?
The CMS HCPCS file marks Q4025 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 Q4025 paid under the physician fee schedule?
Q4025 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.