A2025 Medicaid reimbursement rate by state (2026)
Miro3d, per cubic centimeter (add-on. Medicaid pays a median of $92.95 for A2025 across 7 states, from $50.55 in Indiana to $250.00 in Arizona.
- States publishing
- 7
- National median
- $92.95units vary by state
- Lowest
- $50.55Indiana
- Highest
- $250.00Arizona
What does Medicaid pay for A2025?
7 state Medicaid programs publish a fee-for-service rate for A2025. The national median is $92.95 (units differ between states). Arizona pays the most, $250.00, and Indiana the least, $50.55 per unit, a 4.9x spread.
Medicare (non-facility, 2026 physician fee schedule): $116.19–$149.91 depending on the state's Medicare locality.
A2025 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 7 states with every variant, modifier and effective date.
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 A2025, 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. 3 of the 7 states list more than one rate for A2025, 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 7 states, 1 publish A2025 per unit, and 6 schedules print no unit at all (a flat amount per service).
- Per hour. A2025 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. Medicare amounts exist for A2025, but no state's Medicaid unit matches Medicare's billing unit closely enough to compute a percentage.
- Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.
Why A2025 rates differ between states
Published rates for A2025 run from $50.55 in Indiana to $250.00 in Arizona. The two publish it in different units (no unit printed versus unit), so part of that gap is the unit rather than the price. Half the states pay more than the median of $92.95 and half pay less. The usual reasons for a spread like this in pharmacy rates:
- For children, many vaccines are supplied through the federal Vaccines for Children program, so the Medicaid payment can be for administration only.
- States differ in whether they pay a fixed fee, a percentage of a benchmark or invoice cost.
- Drugs given in a practice or clinic are commonly priced from a benchmark such as average sales price or wholesale acquisition cost, which moves every quarter.
Timing matters too. 7 states set the current rate for A2025 in 2026 or later. A state that has not updated its rate in years will drift down the ranking as others raise theirs.
What managed-care plans pay for A2025
What a plan pays for A2025 is negotiated privately, but the state decides how much room there is to negotiate. Here is how the rules break down across the 7 states.
In 1 state, the published rate binds plans: a floor, a pass-through or a state-set rate. In 3 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 3 states is not classified yet.
- Plans negotiate; the published rate applies out of network (3 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 (1 state). 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 Arizona managed care.
Units and billing for A2025
A2025 is a HCPCS Level II transportation and supply code in the pharmacy line, billed mostly by practices and clinics that administer vaccines and drugs. 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.
Drug codes are billed in units of the dose stated in the code, so a larger dose bills more units. Many states require the National Drug Code (NDC) on the claim alongside the billing code.
Medicare's 2026 physician fee schedule pays $116.19–$149.91 for A2025 (non-facility), depending on the Medicare locality. That is a useful reference point, but Medicare and Medicaid can define the unit differently, so compare only where the units match.
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.
Frequently asked questions
What does Medicaid pay for A2025?
It depends on the state. Of the 7 states with a published fee-for-service rate, the median is $92.95. Arizona pays the most ($250.00) and Indiana the least ($50.55 per unit).
Which state pays the highest Medicaid rate for A2025?
Arizona, at $250.00, effective 2026-08-01.
Which state pays the lowest Medicaid rate for A2025?
Indiana, at $50.55 per unit, effective 2026-01-01. It publishes the code in a different unit from Arizona, so compare per unit with care.
What unit is A2025 billed in?
Of the 7 states, 1 publish A2025 per unit, and 6 schedules print no unit at all (a flat amount per service).
Do managed-care plans pay the same rate for A2025?
Not necessarily. In 1 state, the published rate binds plans: a floor, a pass-through or a state-set rate. In 3 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 3 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.