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Billing code A6402 · Equipment & supplies

A6402 Medicaid reimbursement rate by state (2026)

Gauze, non-impregnated, sterile. Medicaid pays a median of $0.13 for A6402 across 47 states, from $0.09 in New Jersey to $0.37 in New Hampshire.

Data as of Oct 5, 202647 statesEvery rate links to its official source

States publishing
47
National median
$0.13units vary by state
Lowest
$0.09New Jersey
Highest
$0.37New Hampshire
Answer

What does Medicaid pay for A6402?

47 state Medicaid programs publish a fee-for-service rate for A6402. The national median is $0.13 (units differ between states). New Hampshire pays the most, $0.37, and New Jersey the least, $0.09, a 4.1x spread.

State ranking

A6402 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 47 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1New Hampshire Source · since 2021-01-01$0.37——Not classified—
2North Dakota Source · since 2026-07-01$0.27——Not classified—
3New Mexico Source · since 2025-01-01$0.23——Plans must pay at least this—
23South Carolina Source · since 2019-07-01$0.13——Not classified—
24Idaho Source · since 2025-09-01$0.13——Not classified—
25Vermont Source · since 2025-01-01$0.13——Not classified—
46Connecticut Source · since 2007-05-01$0.10——Not classified—
47New Jersey Source · since 2025-01-01$0.09——Not classified—
See all 47 states for A6402 — start free

39 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 A6402 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 A6402, 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. 20 of the 47 states list more than one rate for A6402, 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 47 states, 4 publish A6402 per unit, and 43 schedules print no unit at all (a flat amount per service).
  • Per hour. A6402 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 A6402, 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 A6402 rates differ between states

Published rates for A6402 run from $0.09 in New Jersey to $0.37 in New Hampshire, a 4.1x gap in the same unit. Half the states pay more than the median of $0.13 and half pay less. The usual reasons for a spread like this in equipment & supplies rates:

  • 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.
  • Some items are priced individually from the manufacturer's price or the supplier's invoice, so fewer states publish a fixed fee.

Timing matters too. 10 states set the current rate for A6402 in 2026 or later, while 13 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 A6402

No managed-care plan publishes what it pays for A6402. What is public is the rule each state's plan contracts set, and that rule decides how much the published rate matters when you contract with a plan.

In 8 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 24 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 15 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (24 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 (7 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.
  • The state sets the plan rate (1 state). There is little to negotiate on price. Contracting is about network participation, authorization and billing terms.

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 New Hampshire managed care.

Billing

Units and billing for A6402

A6402 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 A6402?

It depends on the state. Of the 47 states with a published fee-for-service rate, the median is $0.13. New Hampshire pays the most ($0.37) and New Jersey the least ($0.09).

Which state pays the highest Medicaid rate for A6402?

New Hampshire, at $0.37, effective 2021-01-01.

Which state pays the lowest Medicaid rate for A6402?

New Jersey, at $0.09, effective 2025-01-01.

What unit is A6402 billed in?

Of the 47 states, 4 publish A6402 per unit, and 43 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for A6402?

Not necessarily. In 8 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 24 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 15 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.