A4252 Medicaid reimbursement rates by state
Blood ketone test or reagent strip, each. 8 state Medicaid programs publish a fee-for-service rate for A4252. Rates run from $0.01 in Missouri to $6.39 in Idaho, with a median of $4.50.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 8
- Median rate
- $4.50units vary by state
- Highest
- $6.39Idaho
- Medicare (non-facility)
- —not on the physician fee schedule
A4252 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.
| State | Medicaid rate | Unit | Per hour | Managed-care plans | % of Medicare | Source |
|---|---|---|---|---|---|---|
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $6.39since 2025-09-01 | — | — | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
| TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP) | $6.24since 2017-04-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Dmepo |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $5.95since 2021-01-01 | — | — | Not classified | — | 2026 Fee Schedule - Covered Procedures R |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $4.50since 2025-01-01 | — | — | Not classified | — | SCDHHS Durable Medical Equipment (DME) F |
| New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service) | $4.49since 2022-06-01 | — | — | Plans negotiate; applies out of network | — | eMedNY NYS Medicaid DMEPOS Fee Schedule |
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $4.41since 2022-07-01 | — | — | Not classified | — | Health First Colorado Physician Fee Sche |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $4.37since 2026-01-01 | — | — | Not classified | — | MaineCare Section 60, Medical Supplies a |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $0.01since 2008-01-01 | — | — | Plans negotiate; applies out of network | — | MO HealthNet fee schedule: Home Health |
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 A4252?
It depends on the state. Of the 8 states with a published fee-for-service rate, the median is $4.50. Idaho pays the most ($6.39) and Missouri the least ($0.01).
Which state pays the highest Medicaid rate for A4252?
Idaho, at $6.39, effective 2025-09-01.
Do managed-care plans pay the same rate for A4252?
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.