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A4402 Medicaid reimbursement rates by state

Lubricant, per ounce. 48 state Medicaid programs publish a fee-for-service rate for A4402 at the nurse midwife level. Rates run from $0.30 in Michigan to $5.59 in Hawaii, with a median of $1.74.

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

States publishing
48
Median rate
$1.74units vary by state
Highest
$5.59Hawaii
Medicare (non-facility)
—not on the physician fee schedule

A4402 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$5.59⚠ over 3× mediansince 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)$5.36⚠ over 3× mediansince 2026-01-01——Not classified—Alaska Medicaid DMEPOS Interim Fee Sched
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$2.85since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
North DakotaAny qualified provider (rate does not vary by provider) · North Dakota Medicaid (fee-for-service)$2.85since 2026-07-01——Not classified—ND Medicaid DME and Supplies Fee Schedul
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$2.57since 2025-05-16——Not classified—Arkansas Medicaid Home Health Fee Schedu
ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$2.44since 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)$2.27since 2026-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$2.27since 2026-01-01——Not classified—MaineCare Section 60, Medical Supplies a
MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service)$2.27since 2026-01-01——Not classified—Montana Healthcare Programs fee schedule
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$2.04since 2026-01-01Per Ounce—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)$2.04since 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)$2.04since 2026-07-01——Not classified—Wyoming Medicaid Downloadable Fee Schedu
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$1.99since 2026-01-01——Plans must pay at least this—SoonerCare Durable Medical Equipment Rat
DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP)$1.99since 2026-01-01——Plans negotiate; applies out of network—DMAP 2026 Physician Fee Schedule
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$1.93since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$1.91since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$1.90since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$1.90since 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)$1.84since 2024-07-01——Not classified—SCDHHS Durable Medical Equipment (DME) F
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$1.83since 2025-01-01——Not classified—Vermont Medicaid Fee Schedule - DME Code
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$1.82since 2026-04-01——Plans must pay at least this—BMS DME 2026 Rural Fee Schedule Effectiv
IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$1.79since 2024-07-01——State sets the plan rate—Iowa Medicaid fee schedule #08 PHARMACY
NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$1.77since 2017-01-01——Plans negotiate; applies out of network—Provider Type 33, Durable Medical Equipm
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$1.74since 2024-10-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$1.74since 2026-07-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$1.72since 2021-01-01——Plans negotiate; applies out of network—HCA Medical equipment and supplies fee s
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$1.72since 2026-07-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$1.62since 2026-07-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
District of ColumbiaAny qualified provider (rate does not vary by provider) · DC Medicaid (DHCF) fee-for-service$1.59since 2026-04-01——Not classified—REFRP00178CSV - Medical Fee Schedule Rep
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$1.57since 2026-03-01——Plans negotiate; applies out of network—Rates for Durable Medical Equipment, Oxy
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$1.57since 2022-10-17——Plans negotiate; applies out of network—MO HealthNet fee schedule: Durable Medic
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$1.54since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$1.52since 2022-07-01——Not classified—Health First Colorado Physician Fee Sche
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$1.52since 2003-05-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Dmepo
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$1.49since 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)$1.39since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$1.36since 2007-05-01——Not classified—CMAP fee schedule: 10/01/2026 MEDS - Med
FloridaAny qualified provider (rate does not vary by provider) · Florida iBudget waiver for people with developmental disabilities (APD)$1.35since 2015-10-19——Paid by the state, outside plans—Developmental Disabilities Individual Bu
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$1.32since 2025-10-011 ounce—Plans negotiate; applies out of network—NC Medicaid fee schedule 'Home Health Se
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$1.28since 2026-05-20——Not classified—EPSDT Referral (DME) Fee Schedule (REF-0
Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service)$1.25since 2012-07-01——Plans negotiate; applies out of network—RI Medicaid Interactive Fee For Service
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$1.23since 2024-01-01——Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2024-01-
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$1.09since 2016-07-01——Plans negotiate; applies out of network—DME Fee Schedule - Excel.xlsx
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$0.90since 2005-12-12——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$0.65since 1998-08-01Ounce—Plans negotiate; applies out of network—ODM DMEPOS payment schedule (appendix to
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$0.44since 2023-04-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$0.38since 2008-07-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Supplies
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$0.30since 2023-01-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost

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 A4402?

It depends on the state. Of the 48 states with a published fee-for-service rate, the median is $1.74. Hawaii pays the most ($5.59) and Michigan the least ($0.30).

Which state pays the highest Medicaid rate for A4402?

Hawaii, at $5.59, effective 2026-06-01.

Do managed-care plans pay the same rate for A4402?

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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