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A4238 Medicaid reimbursement rates by state

Supply allowance for adjunctive. 30 state Medicaid programs publish a fee-for-service rate for A4238. Rates run from $185.98 in South Carolina to $841.59 in Colorado, with a median of $261.95.

Data as of 2026-10-05. Every rate links to the official document it came from.

States publishing
30
Median rate
$261.95units vary by state
Highest
$841.59Colorado
Medicare (non-facility)
—not on the physician fee schedule

A4238 rate in every state

One like-for-like fee-for-service rate per state, highest first. Units can differ between states; the per-hour column converts time-based units.

StateMedicaid rateUnitPer hourManaged-care plans% of MedicareSource
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$841.59⚠ over 3× mediansince 2025-10-01——Not classified—Health First Colorado Physician Fee Sche
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$335.00since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$280.71since 2026-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$280.71since 2026-06-09——Not classified—Arkansas Medicaid Prosthetics (includes
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$280.71since 2026-01-01——Not classified—MaineCare Section 60, Medical Supplies a
MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service)$280.71since 2026-01-01——Not classified—Montana Healthcare Programs fee schedule
DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP)$280.71since 2026-01-01——Plans negotiate; applies out of network—DMAP 2026 DME Fee Schedule
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$275.21since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$270.89since 2026-07-01——Plans negotiate; applies out of network—HCA Home infusion therapy/parenteral nut
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$268.76since 2026-03-01——Plans negotiate; applies out of network—Rates for Durable Medical Equipment, Oxy
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$268.76since 2024-05-15——State sets the plan rate—KY Medicaid DME fee schedule (2024Medica
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$261.95since 2023-04-01——Plans negotiate; applies out of network—Copy of Durable Medical Equipment Servic
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$261.95since 2025-10-01——Plans negotiate; applies out of network—NC Medicaid fee schedule 'Durable Medica
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$261.95since 2023-01-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Dmepo
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$261.95since 2023-04-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$261.95since 2022-04-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$259.01since 2024-07-01——State sets the plan rate—Iowa Medicaid fee schedule #08 PHARMACY
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$252.64since 2026-01-011 unit =1 month—Plans must pay at least this—DMAS procedure fee file hcpcmedical.csv
South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services)$251.16since 2026-07-01——Not classified—South Dakota Medicaid DME fee schedule (
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$248.19since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$238.60since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$224.57since 2026-07-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$224.57since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$215.01since 2025-01-01——Not classified—2026 Fee Schedule - Covered Procedures R
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$210.00since 2024-01-01Each—Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$209.56since 2023-09-05——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
District of ColumbiaAny qualified provider (rate does not vary by provider) · DC Medicaid (DHCF) fee-for-service$209.56since 2023-04-01——Not classified—REFRP00178CSV - Medical Fee Schedule Rep
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$207.24since 2023-06-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$196.50since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$185.98since 2022-04-01——Not classified—SCDHHS Durable Medical Equipment (DME) F

Rates marked ⚠ are more than three times the median for the same unit; they are published as shown but often reflect an office (non-facility) fee or a different scope of service. 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 with the CMS formula; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Frequently asked questions

What does Medicaid pay for A4238?

It depends on the state. Of the 30 states with a published fee-for-service rate, the median is $261.95. Colorado pays the most ($841.59) and South Carolina the least ($185.98).

Which state pays the highest Medicaid rate for A4238?

Colorado, at $841.59, effective 2025-10-01.

Do managed-care plans pay the same rate for A4238?

Not necessarily. Each state's plan contracts decide whether plans must pay at least the fee-for-service rate, pay a state-set rate, or negotiate their own. The table shows the rule for each state, cited to the contract or statute.

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