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Billing code A7524 · Equipment & supplies

A7524 Medicaid reimbursement rate by state (2026)

Tracheostoma stent/stud/button, each. Medicaid pays a median of $88.26 for A7524 across 39 states, from $2.26 in Kentucky to $118.50 in Arizona.

Data as of Oct 5, 202639 statesEvery rate links to its official source

States publishing
39
National median
$88.26units vary by state
Lowest
$2.26Kentucky
Highest
$118.50Arizona
Answer

What does Medicaid pay for A7524?

39 state Medicaid programs publish a fee-for-service rate for A7524. The national median is $88.26 (units differ between states). Arizona pays the most, $118.50, and Kentucky the least, $2.26, a 52.4x spread.

State ranking

A7524 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 39 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Arizona Source · since 2026-10-01$118.50——Plans negotiate; applies out of network—
2Minnesota Source · since 2026-01-01$110.33——Plans negotiate; applies out of network—
3Oklahoma Source · since 2026-01-01$110.33——Plans must pay at least this—
19Mississippi Source · since 2026-07-01$88.26——Plans must pay at least this—
20West Virginia Source · since 2026-04-01$88.26——Plans must pay at least this—
21Ohio Source · since 2026-01-01$86.53——Plans negotiate; applies out of network—
38Kansas Source · since 2026-07-01$27.58——Not classified—
39Kentucky Source · since 2022-01-01$2.26——Plans negotiate; applies out of network—
See all 39 states for A7524 — start free

31 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.

  • Source for every rate
  • Full rate history
  • CSV and API export

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 A7524 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 A7524, 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. 12 of the 39 states list more than one rate for A7524, 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 39 states, 2 publish A7524 per unit, and 37 schedules print no unit at all (a flat amount per service).
  • Per hour. A7524 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 A7524, 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 A7524 rates differ between states

Published rates for A7524 run from $2.26 in Kentucky to $118.50 in Arizona, a 52.4x gap in the same unit. Half the states pay more than the median of $88.26 and half pay less. The usual reasons for a spread like this in equipment & supplies rates:

  • 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.
  • Many states set equipment and supply fees as a percentage of the Medicare DMEPOS fee schedule, at different percentages and from different years.

Timing matters too. 21 states set the current rate for A7524 in 2026 or later, while 11 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 A7524

Most Medicaid members are in managed-care plans, and plans don't publish their provider fee schedules. For A7524, the public signal is the rule each state sets for its plans, recorded on each rate above.

In 8 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 19 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 12 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (19 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 Arizona managed care.

Billing

Units and billing for A7524

A7524 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 A7524?

It depends on the state. Of the 39 states with a published fee-for-service rate, the median is $88.26. Arizona pays the most ($118.50) and Kentucky the least ($2.26).

Which state pays the highest Medicaid rate for A7524?

Arizona, at $118.50, effective 2026-10-01.

Which state pays the lowest Medicaid rate for A7524?

Kentucky, at $2.26, effective 2022-01-01.

What unit is A7524 billed in?

Of the 39 states, 2 publish A7524 per unit, and 37 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for A7524?

Not necessarily. In 8 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 19 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 12 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.