People living with Spina Bifida often use intermittent catheterization to manage neurogenic bladder. The quality, comfort, and safety of catheters is essential to prevent complications like urinary tract infections (UTIs) and urethral trauma. Until now, Medicare grouped over 1,300 intermittent catheter products under just three codes, making it difficult to distinguish between basic and advanced catheter technologies like hydrophilic coatings. ¹
Starting January 1, 2026, the Centers for Medicare and Medicaid Services (CMS) will implement new HCPCS codes for intermittent urinary catheters, a change that directly impacts many individuals in the Spina Bifida community who rely on these supplies for daily bladder management. These new codes are designed to recognize the clinical benefit of hydrophilic coating technology but will also expand access and drive innovation¹.
CMS is introducing three new HCPCS codes and revising two existing ones to better differentiate hydrophilic-coated intermittent catheters, which are known to offer smoother insertion, reduced urethral trauma, and lower risk of urinary tract infections (UTIs).
New HCPCS Codes:
- A4295- Straight tip with hydrophilic coating
- A4296-Coudé (curved) tip with hydrophilic coating
- A4297- Catheter with hydrophilic coating, with insertion supplies
Revised Codes:
- A44351- Straight tip, with or without coating (Teflon, silicone, silicone elastomer, etc).
- A4352- Coudé (curved) tip, with or without coating (Teflon, silicone, silicone elastomer, etc)
- A4353- Catheter with insertion supplies (unchanged)
People with Spina Bifida often require lifelong catheterization. Hydrophilic catheters are preferred by many due to their comfort and reduced complications. Until now, these advanced products were grouped together under broad codes, making it difficult to justify their use and secure coverage.
Whether you’re a patient or caregiver, talk to your provider and ensure your prescription specifies hydrophilic catheters if that is what you use. Check with your supplier to confirm their billing systems reflect the new codes. CMS has also indicated that no pricing changes are expected at this time.
This coding update is a positive step forward for the Spina Bifida community. It recognizes the importance of product innovation and empowers patients to receive the care they deserve.
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