Home Health Consolidated Billing Update
- By Renee Dustman
- In Uncategorized
- July 27, 2026
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Effective Oct. 1, 2026, the Centers for Medicare & Medicaid Services (CMS) will add 19 new HCPCS Level II codes to the home health consolidated billing non-routine supply code list.
Types of services subject to home health consolidated billing (HH CB) include:
- Skilled nursing care
- Home health aide services
- Physical therapy
- Speech-language pathology
- Occupational therapy
- Medical social services
- Medical supplies
- Medical services
- Care for homebound patients involving equipment that is not easily transportable
Durable medical equipment is exempt from HH CB.
What are the new codes subject to HH CB?
The 19 new HCPCS Level II “A” codes for non-routine supplies are as follows:
| A4206 | Syringe with needle, sterile, 1 cc or less, each |
| A4207 | Syringe with needle, sterile 2 cc, each |
| A4208 | Syringe with needle, sterile 3 cc, each |
| A4209 | Syringe with needle, sterile 5 cc or greater, each |
| A4210 | Needle-free injection device, each |
| A4211 | Supplies for self-administered injections |
| A4218 | Sterile saline or water, metered dose dispenser, 10 ml |
| A4318 | Female external urinary collection cup, with or without ring attachment, per day |
| A4336 | Incontinence supply, urethral insert, any type, each |
| A4337 | Incontinence supply, rectal insert, any type, each |
| A4341 | Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each |
| A4342 | Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each |
| A4397 | Irrigation supply; sleeve, each |
| A4398 | Ostomy irrigation supply; bag, each |
| A4399 | Ostomy irrigation supply; cone/catheter, with or without brush A4400 Ostomy irrigation set |
| A4450 | Tape, non-waterproof, per 18 square inches |
| A4452 | Tape, waterproof, per 18 square inches |
| A4453 | Rectal catheter with or without balloon, for use with any type transanal irrigation system, each |
What is consolidated billing?
Consolidated billing applies to all home health services while a beneficiary is under a home health plan of care authorized by a physician. As such, Medicare makes payment for all such items and services to a single home health agency (HHA) — the HHA that submitted a Notice of Admission — overseeing that plan, known as the primary HHA.
Medicare does not pay separately for codes subject to consolidated billing when the patient is in an HH episode or under an HH plan of care administered by an HH.
Exceptions to this policy are:
- Therapies physicians perform
- Supplies incidental to physician services
- Supplies used in institutional settings
The master list of all codes subject to home health consolidated billing is available on the CMS.gov website.
Source: MLNMatters MM14510, released July 8, 2026
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