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A4930 Medicaid reimbursement rates by state

Gloves, sterile, per pair. 38 state Medicaid programs publish a fee-for-service rate for A4930 at the nurse midwife level. Rates run from $0.01 in Missouri to $2.52 in Minnesota, with a median of $0.675.

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

States publishing
38
Median rate
$0.675units vary by state
Highest
$2.52Minnesota
Medicare (non-facility)
—not on the physician fee schedule

A4930 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
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$2.52⚠ over 3× mediansince 2026-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$2.26⚠ over 3× mediansince 2022-01-01——Plans negotiate; applies out of network—KY Medicaid Home Health fee schedule (20
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$1.90since 2012-07-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$1.78since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$1.36since 2022-07-01——Not classified—Health First Colorado Physician Fee Sche
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$0.99since 2021-01-01——Plans negotiate; applies out of network—HCA Medical equipment and supplies fee s
South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services)$0.94since 2026-07-01——Not classified—South Dakota Medicaid DME fee schedule (
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$0.88since 2025-10-011 pair—Plans negotiate; applies out of network—NC Medicaid fee schedule 'Home Health Se
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$0.88since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$0.88since 2024-07-01——Not classified—SCDHHS Durable Medical Equipment (DME) F
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$0.83since 2025-09-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$0.82since 2023-03-01——Not classified—Vermont Medicaid Fee Schedule - DME Code
Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service)$0.80since 2012-07-01——Plans negotiate; applies out of network—RI Medicaid Interactive Fee For Service
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$0.75since 2026-01-01——Not classified—MaineCare Section 60, Medical Supplies a
HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service$0.75since 2024-03-04——Plans negotiate; applies out of network—Medicaid Fee-For-Service (FFS) Fee Sched
WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health)$0.73since 2021-01-01——Not classified—Wyoming Medicaid Downloadable Fee Schedu
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$0.70since 2019-07-24——Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2019-07-
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$0.68since 2005-12-12——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$0.68since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$0.67since 2025-09-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Dmepo
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$0.64since 2003-08-01——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)$0.64since 2021-01-01——Not classified—2026 Fee Schedule - Covered Procedures R
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$0.60since 2014-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$0.59since 2023-01-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$0.57since 2010-07-01Per Pair—Plans negotiate; applies out of network—DMAS procedure fee file hcpcmedical.csv
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$0.55since 2003-04-01Pair—Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$0.51since 2018-07-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Supplies
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$0.50since 2013-07-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$0.49since 2020-04-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, June 202
ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$0.47since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP)$0.44since 2024-01-01——Plans negotiate; applies out of network—DMAP 2024 Physician Fee Schedule
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$0.41since 2023-04-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$0.36since 2026-03-01——Plans negotiate; applies out of network—Rates for Durable Medical Equipment, Oxy
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$0.35since 2012-07-01——Plans must pay at least this—Louisiana Medicaid Durable Medical Equip
FloridaAny qualified provider (rate does not vary by provider) · Florida iBudget waiver for people with developmental disabilities (APD)$0.34since 2015-10-19——Paid by the state, outside plans—Developmental Disabilities Individual Bu
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$0.25since 2003-01-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$0.25since 2010-07-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
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 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 A4930?

It depends on the state. Of the 38 states with a published fee-for-service rate, the median is $0.675. Minnesota pays the most ($2.52) and Missouri the least ($0.01).

Which state pays the highest Medicaid rate for A4930?

Minnesota, at $2.52, effective 2026-01-01.

Do managed-care plans pay the same rate for A4930?

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

L0120Cervical, flexible, non-adjustable, prefabricated · 48 statesL0130Cervical, flexible, thermoplastic collar, molded to patient · 48 statesL0140Cervical, semi-rigid, adjustable (plastic collar) · 48 statesL0150Cervical, semi-rigid, adjustable molded chin cup · 48 statesL0172Cervical, collar, semi-rigid thermoplastic foam, two-piece · 48 statesL0174Cervical, collar, semi-rigid, thermoplastic foam · 48 statesL0200Cervical, multiple post collar · 48 statesL0220Thoracic, rib belt, custom fabricated · 48 statesL0450Tlso, flexible, provides trunk support · 48 statesL0472Tlso, triplanar control, hyperextension · 48 statesL0482Tlso, triplanar control · 48 statesL0484Tlso, triplanar control · 48 states
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