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Reimbursement for the ActiCuf Compression Pouch

Reimbursement for the ActiCuf Compression Pouch is available through Medicare and private third-party insurance. However, you will need a prescription to apply for reimbursement.

Reimbursement through Medicare

When requesting reimbursement for the ActiCuf Compression Pouch through Medicare, use the following codes:

  • Medicare HCPCS Billing Code: A4360
    • External urethral clamp or compression device
Assistance in filing a claim

The following medical supply companies will file a claim for reimbursement for ActiCuf Compression Pouch orders placed through them:

Alabama

Respi-Care Inc
Paul Wilcoxson
976 Ronnie McDowell Avenue
Russelville, AL 35654
Phone:  (256) 332-3222
Fax:  (256) 332-0055

Florida

DMR Corp.
14641 Oak Lane
Miami Lakes, FL 33016
Phone: (305) 666-9911
Fax: (305) 666-1601
Will Bill Medicare and Ship to patient.

Franck's Pharmacy
202 S. W. 17th street
Ocala, FL 34471
Phone: (352) 622-4148
Fax: (352) 622-0130

Lake Pharmacy
710 N. Bay Street
Eustis, FL 32726
Phone: (352) 357-5485
Fax: (352) 357-5505

Little Drug Company
412 Canal Street
New Smyrna Beach, FL 32168
Phone: (386) 428-9041
Fax: (386) 423-3290
Will Bill Medicare and Ship to patient.
littledrug@bellsouth.net

Shands Healthcare
"Shands Teaching Hospital and Clinics, Inc"
1600 W. Archer Rd., 1st Floor
Gainesville, FL 32610
Phone: (352) 265-0405
Fax: (352) 265-0133

Georgia

Chi-Ches-ter's
1042 Gray Highway
Macon, GA 31211-1897
Phone: (478) 743-4557
Fax: (478) 743-4051

Iowa

Imperial Medical
(763) 684-1808
info@imperialmedical.com
Will ship to your home*
* Some restrictions may apply.

Maine

Miller Drug
210 State St.
Bangor, ME 04401
Phone: (207) 947-8369
Fax: (207) 947-0894

Massachusetts

Enos Home Oxygen & Medical Supply, Inc
35 Welby Rd
New Bedford, MA 02745
Phone: (508) 992-2146
Fax: (508) 998-6429

Minnesota

Imperial Medical
308 10th Ave. S.
Buffalo, MN 55313
Phone: (763)684-1808
Fax:  (763)684-1803
info@imperialmedical.com
Will ship to your home*
* Some restrictions may apply.

Handi Medical Supply
2505 University Avenue West
St. Paul, MN 55114
(651) 644-9770

Mississippi

Tri-State Medical
612 Delaware Ave., Ste 18
McComb, MS 39648
Phone: (601) 250-1996
Fax: (601) 250-1997

Missouri

Medical West Healthcare Center
9301 Dielman Industrial Ct.
Olivette, MO 63132
Phone: (314) 725-1888
Fax: (314) 725-1444

St. Louis Medical Supply
10821 Manchester Rd.
Kirkwood, MO 63122
Phone: (314) 821-7355
Fax: (314) 821-5102

Nebraska

Keystone Pharmacy & Home Care
7328 Maple Street
Omaha, NE 68134
Phone: (402) 391-2659
Fax: (402) 391-0038

Kubat Pharmacy - Everything Medical
4924 Center Street
Omaha, NE 68106
Phone: (402) 558-8888
Fax: (402) 558-7388
New York

Hylan Medicine Cabinet
1988 Hylan Blvd
Staten Island, NY 10306
Phone: (718) 667-4300
Fax: (718) 351-7867

Robert Jacobson Surgical Pharmacy
359 E. Main St.
Mount Kisco, NY 10549
Phone: (914) 241-4887
Fax: (914) 241-7041

North Carolina

Johnston Medical Supply
514 N. Brightleaf Blvd., Ste 1202
Smithfield, NC 27577
Phone: (919) 934-4997
Fax: (919) 934-9280

Lowry Drug Co., Inc.
750 Hartness Rd.
Statesville, NC 28677
Phone: (919) 934-4997
Fax: (919) 934-9280
Will ship to your home*
* Some restrictions may apply.

Medical Center Pharmacy
124 N. Center St.
Hickory, NC 28601
Phone: (828) 322-7717
Fax: (828) 322-3803

Tarheel Medical Supply, LLC
1201-C Raleigh Rd.
Chapel Hill, NC 27517
Phone: (919) 969-2669
Fax: (919) 969-2644

Rhode Island
  • ENOS Home Oxygen & Medical Supply, Inc.
    35 Welby Road
    New Bedford, MA 02745

    Tel: 1-800-473-4669 or (508) 992-2146
    Contact: Anita Hall ext. 104

    Some restrictions may apply.

    Website: www.enoshomemedical.com
South Carolina

Ford's Drug & Medical
435 E. Main St., Ste 2
Spartanburg, SC 29302
Phone: (864) 585-3325
Fax: (864) 583-6497

Northside Pharmacy
6105 N Kings Hwy
Myrtle Beach, SC 29577
Phone: (843) 449-3325
Fax: (843) 449-6680

Texas

Allumed
1103 W Adams Ave
Temple, TX 76504
Phone: (254) 773-1226
Fax: (254) 773-1227

North Side Medical
1601 West University Dr.
McKinney, TX 75069
Phone: (972) 562-8700
Fax: (972) 542-3709

Texas Medical Supply
1906 W. 18th Street
Houston, TX 77008
Phone: (713) 864-7636
Fax: (713) 864-4518

TexasStar Pharmacy
3033 West Parker Rd, Ste 100
Plano, TX 75023
Phone: (972) 519-8475
Fax: (972) 519-8477

The Medicine Shoppe Pharmacy
1800 N. Travis, Ste E
Sherman, TX 75092
Phone: (903) 892-9291
Fax: (903) 893-1019

Tower Medic Pharmacy
607 W. Magnolia Ave.
Fort Worth, TX 76104
Phone: (817) 923-6774
Fax: (817) 314-7041

Wisconsin

Imperial Medical
(763) 684-1808
info@imperialmedical.com
Will ship to your home*
* Some restrictions may apply.

 

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