A4342 Medicaid reimbursement rates by state
Accessories for patient inserted indwelling intraurethral.... 20 state Medicaid programs publish a fee-for-service rate for A4342 at the physician psychologist level. Rates run from $524.80 in Ohio to $878.06 in Montana, with a median of $774.45.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 20
- Median rate
- $774.45units vary by state
- Highest
- $878.06Montana
- Medicare (non-facility)
- —not on the physician fee schedule
A4342 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 |
|---|---|---|---|---|---|---|
| MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service) | $878.06since 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) | $878.06since 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) | $860.84since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $860.84since 2025-01-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service HCPC |
| HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service | $860.84since 2026-06-01 | — | — | Plans negotiate; applies out of network | — | Medicaid Fee-For-Service (FFS) Fee Sched |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $819.36since 2023-04-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS Arizona Health Care Cost Containm |
| Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service) | $819.36since 2023-04-01 | — | — | Plans negotiate; applies out of network | — | RI Medicaid Interactive Fee For Service |
| IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $806.61since 2025-12-01 | — | — | 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) | $790.25since 2026-01-01 | Each | — | 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) | $790.25since 2026-01-01 | — | — | Not classified | — | South Dakota Medicaid DME fee schedule ( |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $758.64since 2026-07-01 | — | — | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
| VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA) | $736.02since 2026-01-01 | — | — | Not classified | — | Vermont Medicaid Fee Schedule - DME Code |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $714.56since 2026-03-01 | — | — | Plans negotiate; applies out of network | — | Rates for Durable Medical Equipment, Oxy |
| KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $702.45since 2026-07-01 | — | — | Paid by the state, outside plans | — | KMAP Fee Schedule MKN Medicaid (FeeSched |
| District of ColumbiaAny qualified provider (rate does not vary by provider) · DC Medicaid (DHCF) fee-for-service | $702.45since 2026-04-01 | — | — | Not classified | — | REFRP00178CSV - Medical Fee Schedule Rep |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $696.47since 2023-07-01 | — | — | Not classified | — | CMAP fee schedule: 10/01/2026 MEDS - Med |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $672.53since 2025-01-01 | — | — | Not classified | — | 2026 Fee Schedule - Covered Procedures R |
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $652.83since 2026-07-01 | — | — | Not classified | — | Health First Colorado Physician Fee Sche |
| UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan) | $628.38since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Utah Medicaid Coverage and Reimbursement |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $524.80since 2023-04-01 | Each | — | Plans negotiate; applies out of network | — | ODM DMEPOS combined payment schedules (a |
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 A4342?
It depends on the state. Of the 20 states with a published fee-for-service rate, the median is $774.45. Montana pays the most ($878.06) and Ohio the least ($524.80 per Each).
Which state pays the highest Medicaid rate for A4342?
Montana, at $878.06, effective 2026-01-01.
Do managed-care plans pay the same rate for A4342?
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 A4342 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.