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B4035 Medicaid reimbursement rates by state

Enteral feeding supply kit; pump fed, per day. 41 state Medicaid programs publish a fee-for-service rate for B4035. Rates run from $4.35 in New Jersey to $330.77 in Kentucky, with a median of $9.65.

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

States publishing
41
Median rate
$9.65units vary by state
Highest
$330.77Kentucky
Medicare (non-facility)
—not on the physician fee schedule

B4035 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
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$330.77⚠ over 3× mediansince 2020-01-01day—State sets the plan rate—KY Medicaid DME fee schedule (2020Medica
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$15.28since 2026-07-01day—Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$11.95since 2024-01-01day—Plans negotiate; applies out of network—MHCP Fee Schedule (Wayback capture 20250
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$11.65since 2014-01-01day—Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Dmepo
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$11.53since 2021-07-01day—Plans negotiate; applies out of network—HCA Enteral nutrition fee schedule (ente
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$11.38since 2026-01-01Each—Plans must pay at least this—DMAS procedure fee file hcpcmedical.csv
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$11.33since 2012-07-01day—Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$11.07since 2025-10-01day—Plans negotiate; applies out of network—NC Medicaid fee schedule 'Durable Medica
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$11.04since 2024-07-01day—Not classified—SCDHHS Durable Medical Equipment (DME) F
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$10.95since 2018-07-01day—Plans negotiate; applies out of network—MO HealthNet fee schedule: Durable Medic
NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$10.71since 2011-08-01day—Plans negotiate; applies out of network—Provider Type 33, Durable Medical Equipm
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$10.67since 2008-01-01day—Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$10.63since 2021-01-01day—Not classified—2026 Fee Schedule - Covered Procedures R
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$10.30since 2025-01-01day—Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2025-01-
IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$10.29since 2024-07-01day—State sets the plan rate—Iowa Medicaid fee schedule #08 PHARMACY
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$9.90since 2013-07-01day—Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$9.86since 2026-07-01day—Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$9.83since 2026-07-01day—Not classified—Idaho Medicaid Numerical Fee Schedule Ju
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$9.82since 2013-08-01day—Not classified—CMAP fee schedule: 10/01/2025 MEDS - Par
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$9.77since 2023-07-01day—Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$9.65since 2016-07-01day—Plans negotiate; applies out of network—DME Fee Schedule - Excel.xlsx
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$9.52since 2026-01-01day—Not classified—Vermont Medicaid Fee Schedule - DME Code
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$9.23since 2026-07-01day—Plans negotiate; applies out of network—Durable Medical Equipment and Medical Su
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$9.10since 2026-05-27day—Not classified—DME/POP Fee Schedule (REF-0132-Q)
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$9.10since 2026-07-01day—Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$8.86since 2026-10-01day—Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$8.29since 2026-01-01day—Plans must pay at least this—SoonerCare Durable Medical Equipment Rat
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$8.24since 2010-07-01day—Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$7.62since 2023-01-01day—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)$7.33since 2020-04-01day—Plans negotiate; applies out of network—ForwardHealth max fee schedule: Supplies
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$7.18since 2021-09-01day—Plans must pay at least this—Louisiana Medicaid Durable Medical Equip
MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service)$7.14since 2026-01-01day—Not classified—Montana Healthcare Programs fee schedule
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$6.79since 2010-01-01Each—Plans negotiate; applies out of network—ODM DMEPOS payment schedule (appendix to
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$6.71since 2025-08-12day—Not classified—Arkansas Medicaid Hyperalimentation Fee
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$6.29since 2026-01-01day—Not classified—MaineCare Section 60, Medical Supplies a
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$5.81since 2026-01-01day—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$5.72since 2022-06-01day—Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$5.67since 2026-04-01day—Plans must pay at least this—BMS DME 2026 Non-Rural Fee Schedule Effe
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$5.06since 2026-03-01day—Plans negotiate; applies out of network—Rates for Durable Medical Equipment, Oxy
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$4.95since 2022-07-01day—Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$4.35since 2026-07-01day—Not classified—NJMMIS Procedure Master Listing CPTHCPCS

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 B4035?

It depends on the state. Of the 41 states with a published fee-for-service rate, the median is $9.65. Kentucky pays the most ($330.77 per day) and New Jersey the least ($4.35 per day).

Which state pays the highest Medicaid rate for B4035?

Kentucky, at $330.77 per day, effective 2020-01-01.

Do managed-care plans pay the same rate for B4035?

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

A7000Canister, disposable, used with suction pump, each · 42 statesA8001Helmet, protective, hard, prefabricated · 42 statesB9002Enteral nutrition infusion pump, any type · 42 statesE0105Cane, quad or three prong, includes canes of all materials · 42 statesE0130Walker, rigid (pickup), adjustable or fixed height · 42 statesE0135Walker, folding (pickup), adjustable or fixed height · 42 statesE0143Walker, folding, wheeled, adjustable or fixed height · 42 statesE0149Walker, heavy duty, wheeled, rigid or folding, any type · 42 statesE0163Commode chair, mobile or stationary, with fixed arms · 42 statesE0185Gel or gel-like pressure pad for mattress · 42 statesE0271Mattress, innerspring · 42 statesE0470Respiratory assist device, bi-level pressure capability · 42 states
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