A4268 Medicaid reimbursement rates by state
Contraceptive supply, condom, female, each. 33 state Medicaid programs publish a fee-for-service rate for A4268 at the physician psychologist level. Rates run from $0.06 in Louisiana to $12.42 in North Carolina, with a median of $2.47.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 33
- Median rate
- $2.47units vary by state
- Highest
- $12.42North Carolina
- Medicare (non-facility)
- —not on the physician fee schedule
A4268 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 |
|---|---|---|---|---|---|---|
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $12.42⚠ over 3× mediansince 2025-10-01 | — | — | Plans must pay at least this | — | NC Medicaid fee schedule 'Local Health D |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $10.83⚠ over 3× mediansince 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services) | $3.97since 2026-07-01 | — | — | Not classified | — | South Dakota Medicaid Physician fee sche |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $3.88since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service) | $3.54since 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) | $3.53since 2023-01-01 | — | — | Not classified | — | Health First Colorado Physician Fee Sche |
| MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service) | $3.46since 2025-07-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $3.44since 2004-01-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Medical- |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $3.30since 2025-01-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $3.18since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $3.10since 2009-02-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file hcpcmedical.csv |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $2.95since 2026-07-04 | — | — | Not classified | — | CMAP fee schedule: Clinic - Family Plann |
| TexasPhysician or licensed psychologist (incl. BCBA-D) · Texas Medicaid (fee-for-service, TMHP) | $2.83since 2010-10-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Physi |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $2.66since 2021-01-01 | — | — | Not classified | — | 2026 Fee Schedule - Covered Procedures R |
| AlaskaPhysician or licensed psychologist (incl. BCBA-D) · Alaska Medicaid (fee-for-service, Department of Health) | $2.55since 2026-07-01 | — | — | Not classified | — | Alaska Medicaid Physician Fee Schedule S |
| HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service | $2.50since 2024-03-04 | — | — | Plans negotiate; applies out of network | — | Medicaid Fee-For-Service (FFS) Fee Sched |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $2.47since 2025-01-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service HCPC |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $2.32since 2020-08-01 | — | — | Plans must pay at least this | — | SoonerCare Durable Medical Equipment Rat |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $2.25since 2008-01-01 | — | — | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $2.14since 2025-05-01 | — | — | Plans negotiate; applies out of network | — | Rates for Family Planning Services (effe |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $2.10since 2003-04-01 | Each | — | Plans negotiate; applies out of network | — | ODM DMEPOS combined payment schedules (a |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $2.05since 2021-01-01 | — | — | Plans negotiate; applies out of network | — | HCA Family planning fee schedule (family |
| WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health) | $1.95since 2021-07-01 | — | — | Not classified | — | Wyoming Medicaid Downloadable Fee Schedu |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $1.13since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | HFS School Based Health Services Fee Sch |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $0.95since 2014-08-01 | — | — | Plans negotiate; applies out of network | — | SCDHHS Nurse Midwives Fee Schedule (sche |
| KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $0.75since 2013-01-01 | — | — | Paid by the state, outside plans | — | KMAP Fee Schedule MKN Medicaid (FeeSched |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $0.68since 2023-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Child and Adolescent Health Center |
| NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $0.38since 2024-04-01 | — | — | Plans must pay at least this | — | Provider Type 17, Specialty 166, Special |
| IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $0.30since 2013-07-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #22 FAMILY PL |
| MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service) | $0.27since 2015-01-01 | — | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, June 202 |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $0.25since 2021-01-01 | — | — | Plans negotiate; applies out of network | — | KY Medicaid Preventive fee schedule (202 |
| ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $0.11since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Durable |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $0.06since 2012-07-01 | — | — | Plans must pay at least this | — | Louisiana Medicaid Office of Public Heal |
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 A4268?
It depends on the state. Of the 33 states with a published fee-for-service rate, the median is $2.47. North Carolina pays the most ($12.42) and Louisiana the least ($0.06).
Which state pays the highest Medicaid rate for A4268?
North Carolina, at $12.42, effective 2025-10-01.
Do managed-care plans pay the same rate for A4268?
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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Track A4268 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.