B4105 Medicaid reimbursement rates by state
In-line cartridge containing digestive enzyme(s) for enteral.... 13 state Medicaid programs publish a fee-for-service rate for B4105. Rates run from $31.20 in Ohio to $240.07 in Pennsylvania, with a median of $120.16.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 13
- Median rate
- $120.16units vary by state
- Highest
- $240.07Pennsylvania
- Medicare (non-facility)
- —not on the physician fee schedule
B4105 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 |
|---|---|---|---|---|---|---|
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $240.07since 2022-08-29 | — | — | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health) | $199.41since 2026-08-01 | — | — | Not classified | — | Wyoming Medicaid Downloadable Fee Schedu |
| MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service) | $137.62since 2025-01-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP) | $131.19since 2026-09-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Dmepo |
| IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $130.83since 2024-07-01 | — | — | State sets the plan rate | — | Iowa Medicaid fee schedule #08 PHARMACY |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $128.62since 2024-10-01 | — | — | Plans negotiate; applies out of network | — | Durable Medical Equipment Fee Schedule - |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $120.16since 2025-09-01 | — | — | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $119.64since 2024-01-01 | — | — | Plans negotiate; applies out of network | — | HFS DME Fee Schedule (effective 2024-01- |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $109.75since 2021-12-15 | — | — | Plans negotiate; applies out of network | — | MO HealthNet fee schedule: Durable Medic |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $102.70since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service) | $90.90since 2022-06-01 | — | — | Plans negotiate; applies out of network | — | eMedNY NYS Medicaid DMEPOS Fee Schedule |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $59.53since 2021-01-01 | — | — | Not classified | — | 2026 Fee Schedule - Covered Procedures R |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $31.20since 2019-04-01 | Each | — | Plans negotiate; applies out of network | — | ODM DMEPOS payment schedule (appendix to |
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 B4105?
It depends on the state. Of the 13 states with a published fee-for-service rate, the median is $120.16. Pennsylvania pays the most ($240.07) and Ohio the least ($31.20 per Each).
Which state pays the highest Medicaid rate for B4105?
Pennsylvania, at $240.07, effective 2022-08-29.
Do managed-care plans pay the same rate for B4105?
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.