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Billing code A0394 · Transportation

A0394 Medicaid reimbursement rate by state (2026)

Als specialized service disposable supplies; iv drug therapy. Medicaid pays a median of $9.86 for A0394 across 5 states, from $1.00 in Virginia to $41.07 in Wisconsin.

Data as of Oct 5, 20265 statesEvery rate links to its official source

States publishing
5
National median
$9.86units vary by state
Lowest
$1.00Virginia
Highest
$41.07Wisconsin
Answer

What does Medicaid pay for A0394?

5 state Medicaid programs publish a fee-for-service rate for A0394. The national median is $9.86 (units differ between states). Wisconsin pays the most, $41.07, and Virginia the least, $1.00, a 41.1x spread.

State ranking

A0394 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 5 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Wisconsin Source · since 2023-02-01$41.07——Plans negotiate; applies out of network—
2Vermont Source · since 2023-07-01$35.01——Not classified—
3New Hampshire Source · since 2023-07-01$9.86——Plans must pay at least this—
See all 5 states for A0394 — start free

2 more states, with every modifier and provider-type variant, rate history and the plan rule in each state. 14-day free trial, no credit card.

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Rates are per the unit shown for each state; units can differ between states. Medicare amounts are computed from the CMS relative value file and locality cost indices; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Track A0394 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
Guide

How to read this table

  • Order. States are listed from the highest published rate to the lowest. No single unit is shared by 8 or more states for A0394, so the order is by published amount and is not a like-for-like rank.
  • Medicaid rate. The most the state's fee-for-service program pays for one unit, as published. 1 of the 5 states list more than one rate for A0394, by modifier, provider type or setting; the table shows the one that matches the provider level and setting used across states, without add-ons.
  • Unit. None of the 5 schedules prints a separate unit for A0394, so each amount is a flat payment for one service as the code defines it.
  • Per hour. A0394 is not billed in time units in these states, so no hourly figure is shown.
  • Managed-care plans. The rule the state sets for its plans on this rate. What each rule means is explained below.
  • % of Medicare. No Medicare physician fee schedule amount is on file for A0394, so there is no percentage.
  • Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.
Context

Why A0394 rates differ between states

Published rates for A0394 run from $1.00 in Virginia to $41.07 in Wisconsin, a 41.1x gap in the same unit. Half the states pay more than the median of $9.86 and half pay less. The usual reasons for a spread like this in transportation rates:

  • Many states run non-emergency medical transportation through a broker, so the state fee schedule covers only part of the benefit.
  • Ambulance payment is usually a base rate per transport plus mileage, and states weight the two differently.
  • Emergency and non-emergency trips, advanced and basic life support, and urban and rural trips can each carry their own rates.

Timing matters too. None of the states changed its rate for A0394 in 2026, while 2 states still pay a rate that took effect in 2022 or earlier. A state that has not updated its rate in years will drift down the ranking as others raise theirs.

Managed care

What managed-care plans pay for A0394

Most Medicaid members are in managed-care plans, and plans don't publish their provider fee schedules. For A0394, the public signal is the rule each state sets for its plans, recorded on each rate above.

In 2 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 2 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 1 state is not classified yet.

  • Plans negotiate; the published rate applies out of network (2 states). In-network rates can be above or below the published rate. The published rate is the benchmark both sides know, and the fallback if no contract is signed.
  • Plans must pay at least the published rate (2 states). The published rate is your floor. Negotiate up from it, and if a plan pays less, the contract provision is the basis for a payment dispute.

Plan-negotiated rates are never estimated here. To see the rule and its citation for a particular state, open that state's managed-care page, for example Wisconsin managed care.

Billing

Units and billing for A0394

A0394 is a HCPCS Level II transportation and supply code in the transportation line, billed mostly by ambulance services and non-emergency transportation providers. A codes cover ambulance and transportation services and medical and surgical supplies. Transport codes are paid per trip or per mile; supply codes per item or per box as the code states.

The base rate is billed once per trip and mileage per loaded mile under its own code. Origin and destination modifiers on the claim identify where the trip started and ended.

Before billing, confirm the rate, unit and any modifier with the state's current schedule or the plan: the amounts here are as published, not a guarantee of payment.

FAQ

Frequently asked questions

What does Medicaid pay for A0394?

It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $9.86. Wisconsin pays the most ($41.07) and Virginia the least ($1.00).

Which state pays the highest Medicaid rate for A0394?

Wisconsin, at $41.07, effective 2023-02-01.

Which state pays the lowest Medicaid rate for A0394?

Virginia, at $1.00, effective 2008-04-01.

What unit is A0394 billed in?

None of the 5 schedules prints a separate unit for A0394, so each amount is a flat payment for one service as the code defines it.

Do managed-care plans pay the same rate for A0394?

Not necessarily. In 2 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 2 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 1 state is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.