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Billing code A6525 · Equipment & supplies

A6525 Medicaid reimbursement rate by state (2026)

Gradient compression garment, lower leg and foot, padded. Medicaid pays a median of $696.51 for A6525 across 27 states, from $438.96 in New Hampshire to $923.57 in Arizona.

Data as of Oct 5, 202627 statesEvery rate links to its official source

States publishing
27
National median
$696.51units vary by state
Lowest
$438.96New Hampshire
Highest
$923.57Arizona
Answer

What does Medicaid pay for A6525?

27 state Medicaid programs publish a fee-for-service rate for A6525. The national median is $696.51 (units differ between states). Arizona pays the most, $923.57, and New Hampshire the least, $438.96, a 2.1x spread.

State ranking

A6525 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 27 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Arizona Source · since 2026-10-01$923.57——Plans negotiate; applies out of network—
2Washington Source · since 2026-07-01$773.90——Plans negotiate; applies out of network—
3Minnesota Source · since 2026-01-01$773.90——Plans negotiate; applies out of network—
13Iowa Source · since 2024-07-01$712.10——State sets the plan rate—
14Virginia Source · since 2026-01-01$696.51Each—Plans must pay at least this—
15South Dakota Source · since 2026-01-01$696.51——Not classified—
26Michigan Source · since 2024-04-01$538.46——Plans negotiate; applies out of network—
27New Hampshire Source · since 2024-01-01$438.96——Not classified—
See all 27 states for A6525 — start free

19 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 A6525 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 A6525, 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. 9 of the 27 states list more than one rate for A6525, 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 27 states, 2 publish A6525 per unit, and 25 schedules print no unit at all (a flat amount per service).
  • Per hour. A6525 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 A6525, 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 A6525 rates differ between states

Published rates for A6525 run from $438.96 in New Hampshire to $923.57 in Arizona, a 2.1x gap in the same unit. Half the states pay more than the median of $696.51 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. 16 states set the current rate for A6525 in 2026 or later. 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 A6525

What a plan pays for A6525 is negotiated privately, but the state decides how much room there is to negotiate. Here is how the rules break down across the 27 states.

In 4 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 12 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 11 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (12 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 (3 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 Arizona managed care.

Billing

Units and billing for A6525

A6525 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.

Pricing modifiers decide which amount applies: NU for a new purchase, RR for a monthly rental and UE for used equipment. 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.

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 A6525?

It depends on the state. Of the 27 states with a published fee-for-service rate, the median is $696.51. Arizona pays the most ($923.57) and New Hampshire the least ($438.96).

Which state pays the highest Medicaid rate for A6525?

Arizona, at $923.57, effective 2026-10-01.

Which state pays the lowest Medicaid rate for A6525?

New Hampshire, at $438.96, effective 2024-01-01.

What unit is A6525 billed in?

Of the 27 states, 2 publish A6525 per unit, and 25 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for A6525?

Not necessarily. In 4 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 12 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 11 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.