A4238 Medicare Reimbursement Rate (2026)
Current CMS pricing and breakdown for Supply allowance for adjunctive, non-implanted continuous gl....
A4238 Reimbursement Rate History
| Quarter | Q1 2025 | Q2 2025 | Q3 2025 | Q4 2025 | Q1 2026 | Q2 2026 |
|---|---|---|---|---|---|---|
| National Average Payment | $275.21 | $275.21 | $275.21 | $275.21 | $280.71 | $280.71 |
⚠️ This is a National Estimate
Your actual reimbursement depends on your specific Zip Code and GPCI adjustments (e.g., New York vs. Texas).
Code Description
Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service
Reimbursement Summary
The 2026 National Medicare reimbursement estimate for A4238 is $280.71. Actual payment can vary by locality, setting, and claim specifics.
Description: Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service. For locality-adjusted estimates, use MedFeeSchedule's Medicare Physician Fee Schedule Lookup Tool.
A4238 Reimbursement Rate History
| Quarter | Q1 2025 | Q2 2025 | Q3 2025 | Q4 2025 | Q1 2026 | Q2 2026 |
|---|---|---|---|---|---|---|
| National Average Payment | $275.21 | $275.21 | $275.21 | $275.21 | $280.71 | $280.71 |
Historical Medicare Reimbursement
| Quarter | Non-Facility Rate | Facility Rate | YoY % Change (Non-Fac) | YoY % Change (Fac) |
|---|---|---|---|---|
| 2026 Q2 | $280.71 | $280.71 | +2.00% | +2.00% |
| 2026 Q1 | $280.71 | $280.71 | +2.00% | +2.00% |
| 2025 Q4 | $275.21 | $275.21 | — | — |
| 2025 Q3 | $275.21 | $275.21 | — | — |
| 2025 Q2 | $275.21 | $275.21 | — | — |
| 2025 Q1 | $275.21 | $275.21 | — | — |
Facility vs. Non-Facility (Office) Payment
Facility vs. non-facility pricing most commonly applies to physician services paid under the RVU-based Physician Fee Schedule. For A4238 (DMEPOS Equipment), the payment methodology may not include both facility and non-facility rates.
Q2 2026 Breakdown
| Component | Office (Non-Fac) | Facility (Hosp) |
|---|---|---|
| Work RVU | ||
| Practice Expense (PE) | ||
| Malpractice (MP) | ||
| Total RVUs | 0.00 | 0.00 |
Learn How This Reimbursement Is Calculated
Medicare reimbursement is determined by RVUs, geographic adjustments, and the annual conversion factor.
Frequently Asked Questions
What is the 2026 Medicare rate for A4238?
The 2026 National Average Medicare reimbursement rate for A4238 (DMEPOS Equipment) is $280.71. This rate is effective as of January 1, 2026.
What is the description for code A4238?
Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service
Why do facility and non-facility payments differ for A4238?
Facility vs. non-facility differences usually apply to RVU-based physician services. A4238 may not use both facility and non-facility pricing depending on its payment methodology.
How can I find my local Medicare rate for A4238?
Use MedFeeSchedule's Medicare Physician Fee Schedule Lookup Tool on the homepage to estimate your locality-adjusted reimbursement. Medicare payment can vary based on geographic adjustments (GPCI), place of service, and claim specifics.
Is A4238 covered by Medicare?
Coverage depends on medical necessity, setting, and Medicare policy. Some codes may be bundled, contractor-priced, or restricted. Verify final coverage guidance through CMS or your local MAC when applicable.