A6221 Medicaid reimbursement rates by state
Gauze, non-impregnated, sterile. 19 state Medicaid programs publish a fee-for-service rate for A6221 at the clinical nurse specialist level. Rates run from $0.01 in Missouri to $25.99 in Connecticut, with a median of $2.31.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 19
- Median rate
- $2.31units vary by state
- Highest
- $25.99Connecticut
- Medicare (non-facility)
- —not on the physician fee schedule
A6221 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.
| State | Medicaid rate | Unit | Per hour | Managed-care plans | % of Medicare | Source |
|---|---|---|---|---|---|---|
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $25.99⚠ over 3× mediansince 2003-08-01 | — | — | 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) | $9.11⚠ over 3× mediansince 2022-07-01 | — | — | Not classified | — | Health First Colorado Physician Fee Sche |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $7.23⚠ over 3× mediansince 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) | $4.00since 2007-06-01 | — | — | Paid by the state, outside plans | — | KMAP Fee Schedule MKN Medicaid (FeeSched |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $3.68since 2023-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Medical Suppliers/Orthotists/Prost |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $3.63since 1997-01-01 | — | — | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $3.18since 2021-01-01 | — | — | Plans negotiate; applies out of network | — | HCA Medical equipment and supplies fee s |
| New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service) | $2.44since 2022-06-01 | — | — | Plans negotiate; applies out of network | — | eMedNY NYS Medicaid DMEPOS Fee Schedule |
| TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP) | $2.31since 2025-09-01 | — | — | 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) | $2.31since 2025-05-16 | — | — | Not classified | — | Arkansas Medicaid Home Health Fee Schedu |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $1.95since 2021-09-01 | — | — | Plans must pay at least this | — | Louisiana Medicaid Durable Medical Equip |
| West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services) | $1.93since 2026-04-01 | — | — | Plans must pay at least this | — | BMS DME 2026 Rural Fee Schedule Effectiv |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $1.10since 2008-07-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Supplies |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $1.05since 2025-09-01 | — | — | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $1.03since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Durable |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $0.81since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $0.52since 2006-06-28 | Each | — | Plans negotiate; applies out of network | — | ODM DMEPOS combined payment schedules (a |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $0.17since 2023-01-01 | — | — | Not classified | — | MaineCare Section 60, Medical Supplies a |
| 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 A6221?
It depends on the state. Of the 19 states with a published fee-for-service rate, the median is $2.31. Connecticut pays the most ($25.99) and Missouri the least ($0.01).
Which state pays the highest Medicaid rate for A6221?
Connecticut, at $25.99, effective 2003-08-01.
Do managed-care plans pay the same rate for A6221?
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.