Date: July 1, 2020
To: All Medical Assistance Program Providers
Re: Blood Pressure Monitoring Kit
This notice serves as a reminder that blood pressure monitoring kits are available for all participants who require them, including prenatal or postpartum members. This is a covered benefit for participants covered under a managed care plan as well as traditional Medicaid fee-for-service.
A home blood pressure monitor can be an effective method of supporting pregnant women and new mothers between medical appointments and as an adjunct to telehealth protocols. Providers can order blood pressure equipment for any participant who may benefit from home blood pressure monitoring.
If a participant requires a blood pressure monitoring kit, a health care provider may order a blood pressure monitoring kit, including the appropriately sized cuff, from a durable medical equipment (DME) provider. There are no participant copayments for durable medical equipment and prior approval is not required for the codes below if provided within the benefit limits specified below:
HCPCS Code |
Description |
Max Qty |
Max Days |
A4660 |
Sphygmomanometer/blood pressure apparatus with cuff |
1 |
365 |
A4663 |
Blood pressure cuff only |
1 |
365 |
A4670 |
Automatic blood pressure monitor |
1 |
1,825 |
If a participant has received blood pressure monitoring equipment in the past but requires a replacement prior to the normal benefit limit, prior approval is required for traditional Medicaid participants. For managed care participants, please contact the member’s health plan to arrange a replacement kit.
Questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at 877-782-5565 for participants covered under traditional Medicaid, or to the applicable managed care plan.
Kelly Cunningham
Interim Medicaid Administrator
