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A7523 Medicaid reimbursement rates by state

Tracheostomy shower protector, each. 15 state Medicaid programs publish a fee-for-service rate for A7523. Rates run from $0.51 in Kansas to $29.76 in New Hampshire, with a median of $8.18.

Data as of 2026-10-05. Every rate links to the official document it came from.

States publishing
15
Median rate
$8.18units vary by state
Highest
$29.76New Hampshire
Medicare (non-facility)
—not on the physician fee schedule

A7523 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.

StateMedicaid rateUnitPer hourManaged-care plans% of MedicareSource
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$29.76⚠ over 3× mediansince 2021-01-01——Not classified—2026 Fee Schedule - Covered Procedures R
HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service$25.23⚠ over 3× mediansince 2024-03-04——Plans negotiate; applies out of network—Medicaid Fee-For-Service (FFS) Fee Sched
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$15.72since 2022-07-01——Not classified—Health First Colorado Physician Fee Sche
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$13.90since 2017-04-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Dmepo
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$13.90since 2020-08-01——Plans must pay at least this—SoonerCare Durable Medical Equipment Rat
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$11.28since 2026-01-01——Not classified—MaineCare Section 60, Medical Supplies a
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$10.46since 2024-01-01——Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2024-01-
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$8.18since 2022-06-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$6.80since 2004-02-10——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$5.99since 2019-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Durable Medic
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$5.96since 2023-01-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$5.87since 2008-07-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Supplies
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$1.86since 2004-07-01——Not classified—CMAP fee schedule: 10/01/2026 MEDS - Med
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$0.75since 2013-07-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$0.51since 2004-01-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched

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 A7523?

It depends on the state. Of the 15 states with a published fee-for-service rate, the median is $8.18. New Hampshire pays the most ($29.76) and Kansas the least ($0.51).

Which state pays the highest Medicaid rate for A7523?

New Hampshire, at $29.76, effective 2021-01-01.

Do managed-care plans pay the same rate for A7523?

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.

Related Equipment & supplies codes

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