A0424 Medicaid reimbursement rate by state (2026)

• Order. States are listed from the highest published rate to the lowest. No single unit is shared by 8 or more states for A0424, 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. 5 of the 18 states list more than one rate for A0424, 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. Of the 18 states, 1 publish A0424 per unit, and 17 schedules print no unit at all (a flat amount per service).
• Per hour. A0424 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 A0424, 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.

Published rates for A0424 run from $1.00 in Virginia to $139.40 in Idaho, a 139.4x gap in the same unit. Half the states pay more than the median of $25.14 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. 3 states set the current rate for A0424 in 2026 or later, while 11 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.

Most Medicaid members are in managed-care plans, and plans don't publish their provider fee schedules. For A0424, the public signal is the rule each state sets for its plans, recorded on each rate above.

In 4 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 6 states, plans negotiate and the published rate is a benchmark or out-of-network default. In 3 states, the service is paid outside the plans or through a state-directed payment. The rule for the remaining 5 states is not classified yet.

• Plans negotiate; the published rate applies out of network (6 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 (4 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.
• Paid by the state, outside the plans (3 states). Bill the state's Medicaid program, not the plan, at the published rate. There is no plan contract to negotiate for this service.

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 Idaho managed care.

A0424 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.