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A4618 Medicaid reimbursement rates by state

Breathing circuits. 34 state Medicaid programs publish a fee-for-service rate for A4618 at the nurse midwife level. Rates run from $0.92 in Alabama to $16.50 in New Mexico, with a median of $8.57.

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

States publishing
34
Median rate
$8.57units vary by state
Highest
$16.50New Mexico
Medicare (non-facility)
—not on the physician fee schedule

A4618 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
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$16.50since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$13.76since 2021-01-01——Not classified—2026 Fee Schedule - Covered Procedures R
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$12.12since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$11.57since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$11.41since 2026-01-01Each—Plans must pay at least this—DMAS procedure fee file hcpcmedical.csv
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$10.97since 2026-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$10.63since 2026-01-01——Not classified—Vermont Medicaid Fee Schedule - DME Code
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$10.57since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$9.94since 2026-07-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$9.87since 2013-01-01——Not classified—SCDHHS Durable Medical Equipment (DME) F
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$9.51since 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)$9.51since 2026-01-01——Plans negotiate; applies out of network—DMAP 2026 Physician Fee Schedule
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$9.34since 2026-07-01New Purchase—Not classified—Durable Medical Equipment Fee Schedule (
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$9.31since 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)$9.07since 2025-07-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$8.89since 2005-12-12——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$8.62since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$8.51since 2020-01-01——State sets the plan rate—KY Medicaid DME fee schedule (2020Medica
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$8.20since 2021-07-01——Plans negotiate; applies out of network—HCA Respiratory care fee schedule (respi
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$7.80since 2008-07-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Supplies
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$7.74since 2026-03-01——Plans negotiate; applies out of network—Rates for Durable Medical Equipment, Oxy
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$7.56since 2007-05-01——Not classified—CMAP fee schedule: 10/01/2026 MEDS - Med
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$7.35since 2025-10-01——Plans negotiate; applies out of network—NC Medicaid fee schedule 'Durable Medica
Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service)$6.65since 2009-03-01——Plans negotiate; applies out of network—RI Medicaid Interactive Fee For Service
NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$6.26since 2017-01-01——Plans negotiate; applies out of network—Provider Type 33, Durable Medical Equipm
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$6.19since 2026-07-01——Plans negotiate; applies out of network—Durable Medical Equipment and Medical Su
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$5.29since 2025-09-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Dmepo
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$4.89since 2019-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Durable Medic
IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$4.12since 2024-07-01——State sets the plan rate—Iowa Medicaid fee schedule #08 PHARMACY
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$2.98since 2022-06-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$2.60since 1990-05-01Each—Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$1.78since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$0.96since 2024-10-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$0.92since 2026-05-20——Not classified—EPSDT Referral (DME) Fee Schedule (REF-0

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 A4618?

It depends on the state. Of the 34 states with a published fee-for-service rate, the median is $8.57. New Mexico pays the most ($16.50) and Alabama the least ($0.92).

Which state pays the highest Medicaid rate for A4618?

New Mexico, at $16.50, effective 2025-01-01.

Do managed-care plans pay the same rate for A4618?

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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