A6513 Medicaid reimbursement rates by state
Compression burn mask, face and/or neck, plastic or equal. 7 state Medicaid programs publish a fee-for-service rate for A6513 at the physician psychologist level. Rates run from $0.00 in Arkansas to $165.24 in Wisconsin, with a median of $30.37.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 7
- Median rate
- $30.37units vary by state
- Highest
- $165.24Wisconsin
- Medicare (non-facility)
- —not on the physician fee schedule
A6513 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 |
|---|---|---|---|---|---|---|
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $165.24⚠ over 3× mediansince 2019-01-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Durable |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $152.00⚠ over 3× mediansince 2021-09-01 | — | — | Plans must pay at least this | — | Louisiana Medicaid Durable Medical Equip |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $53.00since 2007-01-02 | — | — | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $30.37since 2013-07-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $20.00since 2006-01-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $0.01since 2006-01-01 | — | — | Plans negotiate; applies out of network | — | MO HealthNet fee schedule: Home Health |
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service) | $0.00since 2025-06-04 | — | — | Not classified | — | Arkansas Medicaid Prosthetics (includes |
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 A6513?
It depends on the state. Of the 7 states with a published fee-for-service rate, the median is $30.37. Wisconsin pays the most ($165.24) and Arkansas the least ($0.00).
Which state pays the highest Medicaid rate for A6513?
Wisconsin, at $165.24, effective 2019-01-01.
Do managed-care plans pay the same rate for A6513?
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.