Summary & Overview
HCPCS Level II A4306: Disposable Drug Delivery System, <50 ml/hr
HCPCS Level II code A4306 designates a disposable drug delivery system with a flow rate under 50 ml per hour. These single-use devices are used for low-flow continuous or intermittent medication administration, commonly in home infusion, outpatient infusion centers, and other non-acute settings. Nationally, A4306 matters because it affects billing for widely used infusion supplies that support chronic therapies, palliative care, and specialty medication delivery outside inpatient environments.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical use and service contexts, typical sites of service, and the common modifiers associated with billing. The publication provides benchmarks and coverage patterns for the code, notes on documentation and coding practice, and context on how A4306 fits within durable medical equipment and infusion supply billing.
This summary orients clinicians, revenue cycle staff, and policy analysts to the clinical purpose of the device, the payer landscape nationally, and the practical billing considerations that influence reimbursement and claims processing for low-flow disposable drug delivery systems.
Billing Code Overview
HCPCS Level II code A4306 represents a disposable drug delivery system with a flow rate of less than 50 ml per hour. This device category typically covers single-use infusion or syringe pump systems designed to deliver low-volume continuous or intermittent medication administration.
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Service type: Durable medical device supply for drug delivery
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Typical site of service: Home health, outpatient infusion centers, and other non-acute settings where low-flow continuous infusion is required
Clinical & Coding Specifications
Clinical Context
A patient with a chronic pain condition or receiving palliative care requires continuous subcutaneous or intravenous infusion of medication at low flow rates (less than 50 mL per hour). A common scenario is a home infusion patient discharged from an acute care hospital after stabilization of nausea, severe pain, or spasticity who needs a disposable ambulatory drug delivery pump for continuous opioid, antiemetic, or antispasmodic therapy. The clinical workflow includes physician order for a continuous infusion device, pharmacy preparation of the infusion solution, home health or infusion nurse education on pump operation and site care, delivery of the disposable pump (HCPCS A4306) to the patient’s residence, verification of device function and infusion rate, and periodic nursing follow-up for line and site assessment and reservoir changes as clinically indicated. Typical sites of service are the patient’s home, hospice residence, or outpatient infusion center when a short-term ambulatory infusion is required.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Use when no specific modifier applies and standard billing is appropriate |
22 |