HCPCS Level II A4239: Supply Allowance for Non-Adjunctive CGM
Commercial payers pay $249 on average nationally for this procedure.
HCPCS Level II code A4239 describes a supply allowance for non-adjunctive, non-implanted continuous glucose monitors (CGMs) and covers all supplies and accessories supplied for the device; the service is billed per unit with 1 month supply = 1 unit of service, typically provided as durable medical equipment supplies for outpatient or home use to support continuous glucose monitoring therapy.
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National Reimbursement Benchmarks
BUCA (average commercial) centers the market near $248.80, with an interquartile spread from $189.70 to $276.90 that implies moderate dispersion among commercial contracts. Blue Cross Blue Shield shows the largest spread: P75 − P25 is $300.10 − $222.20 = $77.90, indicating wider variability in allowed amounts. UnitedHealth Group’s IQR is $252.20 − $151.30 = $100.90, the widest of the listed payers, reflecting substantial contract heterogeneity across networks.
Aetna and Cigna display tighter mid‑range spreads: Aetna’s IQR is $204.00 − $142.80 = $61.20, and Cigna’s IQR is $281.30 − $144.90 = $136.40 (note: while Cigna’s P25 and P50 are the same, its P75 pushes the IQR higher). These differences suggest Blue Cross Blue Shield and UnitedHealth Group have the greatest dispersion, while Aetna is comparatively tighter around its mid‑range, with BUCA sitting near the market average.