Q4004 — Cast supplies, shoulder cast, adult (11 years +), fiberglass
Q4004 is a HCPCS Level II code for cast supplies, shoulder cast, adult (11 years +), fiberglass. It belongs to the Temporary Codes section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusX
Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
Medically Unlikely Edits — units per day
The most units of Q4004 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 2 units MAI 3 — Date of Service Edit: Clinical · Anatomic Consideration
- outpatient
- 2 units MAI 3 — Date of Service Edit: Clinical · Anatomic Consideration
- DME supplier
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for Q4004
- Long descriptor
- Cast supplies, shoulder cast, adult (11 years +), fiberglass
- Short descriptor
- Cast sup shoulder cast fbrgl
- Added
- July 1, 2001
- BETOS
- D1A
- Pricing indicator
- 55 — Other
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Splints and casts, effective 1 October 2014.
Codes adjacent to Q4004
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If Q4004 is not quite right, the correct code is very often within a few positions of it.
- Q3001Radioelements for brachytherapy, any type, each
- Q3014Telehealth originating site facility fee
- Q3027Injection, interferon beta-1a, 1 mcg for intramuscular use
- Q3028Injection, interferon beta-1a, 1 mcg for subcutaneous use
- Q3031Collagen skin test
- Q4001Casting supplies, body cast adult, with or without head, plaster
- Q4002Cast supplies, body cast adult, with or without head, fiberglass
- Q4003Cast supplies, shoulder cast, adult (11 years +), plaster
- Q4005Cast supplies, long arm cast, adult (11 years +), plaster
- Q4006Cast supplies, long arm cast, adult (11 years +), fiberglass
- Q4007Cast supplies, long arm cast, pediatric (0-10 years), plaster
- Q4008Cast supplies, long arm cast, pediatric (0-10 years), fiberglass
- Q4009Cast supplies, short arm cast, adult (11 years +), plaster
- Q4010Cast supplies, short arm cast, adult (11 years +), fiberglass
- Q4011Cast supplies, short arm cast, pediatric (0-10 years), plaster
- Q4012Cast supplies, short arm cast, pediatric (0-10 years), fiberglass
Questions about Q4004
What is HCPCS code Q4004?
Q4004 is a HCPCS Level II code for cast supplies, shoulder cast, adult (11 years +), fiberglass. It sits in the Temporary Codes section.
Does Medicare cover Q4004?
The CMS HCPCS file marks Q4004 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
How is Q4004 paid under the physician fee schedule?
Q4004 carries PFS status code X. Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.