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A4400 Medicaid reimbursement rates by state

Ostomy irrigation set. 43 state Medicaid programs publish a fee-for-service rate for A4400 at the nurse midwife level. Rates run from $0.01 in Missouri to $89.19 in Hawaii, with a median of $48.76.

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

States publishing
43
Median rate
$48.76units vary by state
Highest
$89.19Hawaii
Medicare (non-facility)
—not on the physician fee schedule

A4400 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
HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service$89.19since 2026-06-01——Plans negotiate; applies out of network—Medicaid Fee-For-Service (FFS) Fee Sched
AlaskaAny qualified provider (rate does not vary by provider) · Alaska Medicaid (fee-for-service, Department of Health)$85.06since 2026-01-01——Not classified—Alaska Medicaid DMEPOS Interim Fee Sched
North DakotaAny qualified provider (rate does not vary by provider) · North Dakota Medicaid (fee-for-service)$82.31since 2026-07-01——Not classified—ND Medicaid DME and Supplies Fee Schedul
ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$74.81since 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)$69.65since 2026-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$69.65since 2026-01-01——Plans must pay at least this—SoonerCare Durable Medical Equipment Rat
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$69.65since 2026-01-01——Not classified—MaineCare Section 60, Medical Supplies a
DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP)$69.65since 2026-01-01——Plans negotiate; applies out of network—DMAP 2026 Physician Fee Schedule
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$68.28since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services)$62.69since 2026-01-01——Not classified—South Dakota Medicaid DME fee schedule (
WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health)$58.49since 2023-09-01——Not classified—Wyoming Medicaid Downloadable Fee Schedu
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$58.38since 2026-01-01——Not classified—Vermont Medicaid Fee Schedule - DME Code
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$57.88since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$56.68since 2026-03-01——Plans negotiate; applies out of network—Rates for Durable Medical Equipment, Oxy
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$55.72since 2026-04-01——Plans must pay at least this—BMS DME 2026 Rural Fee Schedule Effectiv
District of ColumbiaAny qualified provider (rate does not vary by provider) · DC Medicaid (DHCF) fee-for-service$55.72since 2026-04-01——Not classified—REFRP00178CSV - Medical Fee Schedule Rep
NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$54.02since 2017-01-01——Plans negotiate; applies out of network—Provider Type 33, Durable Medical Equipm
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$53.28since 2026-01-01Each—Plans must pay at least this—DMAS procedure fee file hcpcmedical.csv
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$52.90since 2021-01-01——Not classified—2026 Fee Schedule - Covered Procedures R
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$51.66since 2026-07-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$51.14since 2022-01-01——Plans negotiate; applies out of network—KY Medicaid Home Health fee schedule (20
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$48.76since 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)$47.83since 2024-07-01——Not classified—SCDHHS Durable Medical Equipment (DME) F
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$47.46since 2021-01-01——Plans negotiate; applies out of network—HCA Medical equipment and supplies fee s
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$47.36since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$47.02since 2025-07-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$46.88since 1997-07-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Dmepo
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$46.87since 2025-05-16——Not classified—Arkansas Medicaid Home Health Fee Schedu
IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$46.29since 2024-07-01——State sets the plan rate—Iowa Medicaid fee schedule #08 PHARMACY
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$45.00since 1997-08-01Each—Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$42.74since 2025-10-01each—Plans negotiate; applies out of network—NC Medicaid fee schedule 'Home Health Se
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$42.04since 2025-01-01——Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2025-01-
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$41.54since 2007-05-01——Not classified—CMAP fee schedule: 10/01/2026 MEDS - Med
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$39.46since 2022-07-01——Not classified—Health First Colorado Physician Fee Sche
Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service)$38.15since 2012-07-01——Plans negotiate; applies out of network—RI Medicaid Interactive Fee For Service
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$36.68since 2023-01-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$34.15since 2014-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$33.23since 2016-07-01——Plans negotiate; applies out of network—DME Fee Schedule - Excel.xlsx
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$33.23since 2026-05-27——Not classified—DME/POP Fee Schedule (REF-0132-Q)
FloridaAny qualified provider (rate does not vary by provider) · Florida iBudget waiver for people with developmental disabilities (APD)$31.70since 2015-10-19——Paid by the state, outside plans—Developmental Disabilities Individual Bu
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$30.39since 2022-06-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$13.50since 1988-09-01——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$0.01since 2003-10-16——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 A4400?

It depends on the state. Of the 43 states with a published fee-for-service rate, the median is $48.76. Hawaii pays the most ($89.19) and Missouri the least ($0.01).

Which state pays the highest Medicaid rate for A4400?

Hawaii, at $89.19, effective 2026-06-01.

Do managed-care plans pay the same rate for A4400?

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.

Related Equipment & supplies codes

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