B4159 Medicaid reimbursement rate by state (2026)
Enteral formula, for pediatrics. Medicaid pays a median of $0.8542 for B4159 across 24 states, from $0.52 in Louisiana to $2.73 in Maine.
- States publishing
- 24
- National median
- $0.8542units vary by state
- Lowest
- $0.52Louisiana
- Highest
- $2.73Maine
What does Medicaid pay for B4159?
24 state Medicaid programs publish a fee-for-service rate for B4159. The national median is $0.8542 (units differ between states). Maine pays the most, $2.73, and Louisiana the least, $0.52, a 5.3x spread.
B4159 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 24 states with every variant, modifier and effective date.
Frequently asked questions
What does Medicaid pay for B4159?
It depends on the state. Of the 24 states with a published fee-for-service rate, the median is $0.8542. Maine pays the most ($2.73) and Louisiana the least ($0.52).
Which state pays the highest Medicaid rate for B4159?
Maine, at $2.73, effective 2026-01-01.
Do managed-care plans pay the same rate for B4159?
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 workspace shows the rule for each state, cited to the contract or statute.