A4381 Medicaid reimbursement rate by state (2026)
Ostomy pouch, urinary, for use on faceplate, plastic, each. Medicaid pays a median of $5.27 for A4381 across 46 states, from $3.52 in Pennsylvania to $11.69 in New Hampshire.
- States publishing
- 46
- National median
- $5.27units vary by state
- Lowest
- $3.52Pennsylvania
- Highest
- $11.69New Hampshire
What does Medicaid pay for A4381?
46 state Medicaid programs publish a fee-for-service rate for A4381. The national median is $5.27 (units differ between states). New Hampshire pays the most, $11.69, and Pennsylvania the least, $3.52, a 3.3x spread.
A4381 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 46 states with every variant, modifier and effective date.
Frequently asked questions
What does Medicaid pay for A4381?
It depends on the state. Of the 46 states with a published fee-for-service rate, the median is $5.27. New Hampshire pays the most ($11.69) and Pennsylvania the least ($3.52).
Which state pays the highest Medicaid rate for A4381?
New Hampshire, at $11.69, effective 2021-01-01.
Do managed-care plans pay the same rate for A4381?
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 workspace shows the rule for each state, cited to the contract or statute.