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Billing code A6228 · Equipment & supplies

A6228 Medicaid reimbursement rate by state (2026)

Gauze, impregnated, water or normal saline, sterile. Medicaid pays a median of $1.89 for A6228 across 18 states, from $0.57 in Arkansas to $3.95 in Kentucky.

Data as of Oct 5, 202618 statesEvery rate links to its official source

States publishing
18
National median
$1.89units vary by state
Lowest
$0.57Arkansas
Highest
$3.95Kentucky
Answer

What does Medicaid pay for A6228?

18 state Medicaid programs publish a fee-for-service rate for A6228. The national median is $1.89 (units differ between states). Kentucky pays the most, $3.95, and Arkansas the least, $0.57, a 6.9x spread.

State ranking

A6228 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 18 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Kentucky Source · since 2022-01-01$3.95——Plans negotiate; applies out of network—
2Hawaii Source · since 2024-03-04$3.88——Plans negotiate; applies out of network—
3Maine Source · since 2026-01-01$3.48——Not classified—
9North Carolina Source · since 2022-04-01$1.97each—Paid by the state, outside plans—
10Kansas Source · since 2007-06-01$1.81——Plans must pay at least this—
11Texas Source · since 2025-09-01$1.64——Plans negotiate; applies out of network—
17Wisconsin Source · since 2008-07-01$0.59——Plans negotiate; applies out of network—
18Arkansas Source · since 2025-05-16$0.57——Not classified—
See all 18 states for A6228 — start free

10 more states, with every modifier and provider-type variant, rate history and the plan rule in each state. 14-day free trial, no credit card.

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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; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Track A6228 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
Guide

How to read this table

  • Order. States are listed from the highest published rate to the lowest. No single unit is shared by 8 or more states for A6228, so the order is by published amount and is not a like-for-like rank.
  • Medicaid rate. The most the state's fee-for-service program pays for one unit, as published. 6 of the 18 states list more than one rate for A6228, by modifier, provider type or setting; the table shows the one that matches the provider level and setting used across states, without add-ons.
  • Unit. Of the 18 states, 1 publish A6228 per unit, and 17 schedules print no unit at all (a flat amount per service).
  • Per hour. A6228 is not billed in time units in these states, so no hourly figure is shown.
  • Managed-care plans. The rule the state sets for its plans on this rate. What each rule means is explained below.
  • % of Medicare. No Medicare physician fee schedule amount is on file for A6228, so there is no percentage.
  • Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.
Context

Why A6228 rates differ between states

Published rates for A6228 run from $0.57 in Arkansas to $3.95 in Kentucky, a 6.9x gap in the same unit. Half the states pay more than the median of $1.89 and half pay less. The usual reasons for a spread like this in equipment & supplies rates:

  • Some items are priced individually from the manufacturer's price or the supplier's invoice, so fewer states publish a fixed fee.
  • Many states set equipment and supply fees as a percentage of the Medicare DMEPOS fee schedule, at different percentages and from different years.
  • A single code can carry separate purchase, rental and used-equipment amounts, and states publish different subsets of them.

Timing matters too. 1 state set the current rate for A6228 in 2026 or later, while 12 states still pay a rate that took effect in 2022 or earlier. A state that has not updated its rate in years will drift down the ranking as others raise theirs.

Managed care

What managed-care plans pay for A6228

Most Medicaid members are in managed-care plans, and plans don't publish their provider fee schedules. For A6228, the public signal is the rule each state sets for its plans, recorded on each rate above.

In 2 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 8 states, plans negotiate and the published rate is a benchmark or out-of-network default. In 1 state, the service is paid outside the plans or through a state-directed payment. The rule for the remaining 7 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (8 states). In-network rates can be above or below the published rate. The published rate is the benchmark both sides know, and the fallback if no contract is signed.
  • Plans must pay at least the published rate (2 states). The published rate is your floor. Negotiate up from it, and if a plan pays less, the contract provision is the basis for a payment dispute.
  • Paid by the state, outside the plans (1 state). Bill the state's Medicaid program, not the plan, at the published rate. There is no plan contract to negotiate for this service.

Plan-negotiated rates are never estimated here. To see the rule and its citation for a particular state, open that state's managed-care page, for example Kentucky managed care.

Billing

Units and billing for A6228

A6228 is a HCPCS Level II transportation and supply code in the equipment & supplies line, billed mostly by durable medical equipment suppliers, orthotists, prosthetists and pharmacies. A codes cover ambulance and transportation services and medical and surgical supplies. Transport codes are paid per trip or per mile; supply codes per item or per box as the code states.

Units follow the code: per item, per pair, per box or per month of rental, so a per-unit comparison only holds when the states use the same unit. Pricing modifiers decide which amount applies: NU for a new purchase, RR for a monthly rental and UE for used equipment.

Before billing, confirm the rate, unit and any modifier with the state's current schedule or the plan: the amounts here are as published, not a guarantee of payment.

FAQ

Frequently asked questions

What does Medicaid pay for A6228?

It depends on the state. Of the 18 states with a published fee-for-service rate, the median is $1.89. Kentucky pays the most ($3.95) and Arkansas the least ($0.57).

Which state pays the highest Medicaid rate for A6228?

Kentucky, at $3.95, effective 2022-01-01.

Which state pays the lowest Medicaid rate for A6228?

Arkansas, at $0.57, effective 2025-05-16.

What unit is A6228 billed in?

Of the 18 states, 1 publish A6228 per unit, and 17 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for A6228?

Not necessarily. In 2 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 8 states, plans negotiate and the published rate is a benchmark or out-of-network default. In 1 state, the service is paid outside the plans or through a state-directed payment. The rule for the remaining 7 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.