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B4220 Medicaid reimbursement rates by state

Parenteral nutrition supply kit; premix, per day. 39 state Medicaid programs publish a fee-for-service rate for B4220 at the dietitian level. Rates run from $4.53 in Ohio to $220.10 in Kentucky, with a median of $9.00.

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

States publishing
39
Median rate
$9.00units vary by state
Highest
$220.10Kentucky
Medicare (non-facility)
—not on the physician fee schedule

B4220 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)$220.10⚠ over 3× mediansince 2020-01-01day—State sets the plan rate—KY Medicaid DME fee schedule (2020Medica
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$14.65since 2022-10-01day—Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$11.84since 2026-01-01day—Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$11.84since 2026-01-01day—Not classified—MaineCare Section 60, Medical Supplies a
MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service)$11.84since 2026-01-01day—Not classified—Montana Healthcare Programs fee schedule
DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP)$11.84since 2026-01-01day—Plans negotiate; applies out of network—DMAP 2026 Physician Fee Schedule
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$11.61since 2026-01-01day—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$11.61since 2025-01-01day—Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service$11.61since 2026-06-01day—Plans negotiate; applies out of network—Medicaid Fee-For-Service (FFS) Fee Sched
South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services)$11.43since 2026-07-01day—Not classified—South Dakota Medicaid Parenteral Therapy
IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$10.65since 2024-07-01day—State sets the plan rate—Iowa Medicaid fee schedule #08 PHARMACY
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$10.23since 2026-07-01day—Not classified—Idaho Medicaid Numerical Fee Schedule Ju
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$10.16since 2026-07-01day—Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$9.95since 2025-08-12day—Not classified—Arkansas Medicaid Hyperalimentation Fee
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$9.93since 2026-01-01day—Not classified—Vermont Medicaid Fee Schedule - DME Code
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$9.64since 2026-03-01day—Plans negotiate; applies out of network—Rates for Durable Medical Equipment, Oxy
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$9.47since 2026-04-01day—Plans must pay at least this—BMS DME 2026 Rural Fee Schedule Effectiv
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$9.07since 2024-04-01day—Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$9.07since 2024-10-01day—Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
TexasDietitian / nutritionist · Texas Medicaid (fee-for-service, TMHP)$9.00since 2014-01-01day—Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - In Ho
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$8.91since 2021-01-01day—Plans negotiate; applies out of network—HCA Home infusion therapy/parenteral nut
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$8.84since 2023-07-01day—Plans must pay at least this—DOM Comprehensive Fee Schedule, June 202
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$8.29since 2026-07-01day—Not classified—NJMMIS Procedure Master Listing CPTHCPCS
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
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$8.09since 2005-12-12day—Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$7.68since 2025-10-01ONE/DAY—Plans negotiate; applies out of network—NC Medicaid fee schedule 'Home Infusion
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$7.63since 2013-07-01day—Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$7.37since 2021-01-01day—Not classified—2026 Fee Schedule - Covered Procedures R
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$7.32since 2019-07-01day—Plans negotiate; applies out of network—MO HealthNet fee schedule: Durable Medic
WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health)$7.29since 2021-01-01day—Not classified—Wyoming Medicaid Downloadable Fee Schedu
NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$7.13since 2011-08-01day—Plans negotiate; applies out of network—Provider Type 33, Durable Medical Equipm
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$6.88since 2007-05-01day—Not classified—CMAP fee schedule: 10/01/2025 MEDS - Par
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$6.71since 2024-07-01day—Not classified—SCDHHS Durable Medical Equipment (DME) F
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$6.61since 2022-07-01day—Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$6.54since 2026-07-01day—Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$6.28since 2023-01-01day—Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$6.06since 2026-05-27day—Not classified—DME/POP Fee Schedule (REF-0132-Q)
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$4.58since 2010-07-01day—Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$4.53since 2010-01-01Each—Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a

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 B4220?

It depends on the state. Of the 39 states with a published fee-for-service rate, the median is $9.00. Kentucky pays the most ($220.10 per day) and Ohio the least ($4.53 per Each).

Which state pays the highest Medicaid rate for B4220?

Kentucky, at $220.10 per day, effective 2020-01-01.

Do managed-care plans pay the same rate for B4220?

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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