A4231 HCPCS Level II code: Infusion set for external insulin pump, needle type
A4231 is the HCPCS code for “Infusion set for external insulin pump, needle type” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
A4231Infusion set for external insulin pump, needle type
Short description: Infusion insulin pump needle
HCPCS · United States
Medicare details
The indicators CMS publishes with A4231 in its October 2026 file. They describe Medicare’s handling, not another payer’s.
- Medicare coverage
- Special coverage instructions apply
- Medicare pricing
- DMEPOS fee schedule – DME supplies (price subject to floors and ceilings)
- Type of service
- Lump sum purchase of DME, prosthetics, orthotics
- BETOS category
- Other DME
- Added
- Jan 1, 1996
Where A4231 sits
- 1A codesAmbulance, supplies and miscellaneous
- 2Active code A4231Infusion set for external insulin pump, needle type
Source and release
- Data release
- HCPCS Level II · October 2026
- Effective date
- Oct 1, 2026
- Publisher
- CMS
This page is built from the HCPCS Level II catalog that Vero Codes reads when it suggests codes: Centers for Medicare & Medicaid Services’s October 2026 release, imported from the publisher’s file and checked against it. The description, notes and structured data come from the same record.
Frequently asked questions
What does HCPCS code A4231 mean?
A4231 is the HCPCS code for “Infusion set for external insulin pump, needle type” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover A4231?
CMS lists A4231’s Medicare coverage as “Special coverage instructions apply” and its pricing as “DMEPOS fee schedule – DME supplies (price subject to floors and ceilings)”. Coverage and payment still depend on the patient, the setting, the documentation and the payer.
Which HCPCS Level II release does this page use?
It uses CMS’s October 2026 release, in effect from Oct 1, 2026 to Dec 31, 2026. It is a reference: confirm the code against the current list and the payer’s rules before you submit it.
Codes beside A4231
All A codesA4223Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately)A4224Supplies for maintenance of insulin infusion catheter, per weekA4225Supplies for external insulin infusion pump, syringe type cartridge, sterile, eachA4226Supplies for maintenance of insulin infusion pump with dosage rate adjustment using therapeutic continuous glucose sensing, per weekA4228Supplies for maintenance of non-insulin, device-drug combination infusion catheter, per weekA4230Infusion set for external insulin pump, non needle cannula typeA4232Syringe with needle for external insulin pump, sterile, 3 ccA4233Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, eachA4234Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, eachA4235Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, eachA4236Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, eachA4238Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service