Q4303 Medicaid reimbursement rate by state (2026)
Complete aa, per square centimeter (add-on. Medicaid pays a median of $119.93 for Q4303 across 11 states, from $50.55 in Indiana to $3,412.79 in California.
- States publishing
- 11
- National median
- $119.93units vary by state
- Lowest
- $50.55Indiana
- Highest
- $3,412.79California
What does Medicaid pay for Q4303?
11 state Medicaid programs publish a fee-for-service rate for Q4303. The national median is $119.93 (units differ between states). California pays the most, $3,412.79, and Indiana the least, $50.55 per unit, a 67.5x spread.
Medicare (non-facility, 2026 physician fee schedule): $116.19–$183.51 depending on the state's Medicare locality.
Q4303 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 11 states with every variant, modifier and effective date.
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 Q4303, 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. 6 of the 11 states list more than one rate for Q4303, 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 11 states, 1 publish Q4303 per unit, and 10 schedules print no unit at all (a flat amount per service).
- Per hour. Q4303 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. Medicare amounts exist for Q4303, but no state's Medicaid unit matches Medicare's billing unit closely enough to compute a percentage.
- Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.
Why Q4303 rates differ between states
Published rates for Q4303 run from $50.55 in Indiana to $3,412.79 in California. The two publish it in different units (no unit printed versus unit), so part of that gap is the unit rather than the price. Half the states pay more than the median of $119.93 and half pay less. The usual reasons for a spread like this in physician & professional rates:
- Each state sets its own physician conversion factor or fee for every code, and many update them on a state budget cycle rather than on Medicare's calendar.
- Primary-care and pediatric add-ons, enhanced rates for certain specialties and targeted increases for access problems change individual codes without moving the rest of the schedule.
- Many schedules pay differently by place of service (office versus facility) and by practitioner, and nurse practitioners and physician assistants are often paid a percentage of the physician amount.
Timing matters too. 9 states set the current rate for Q4303 in 2026 or later. A state that has not updated its rate in years will drift down the ranking as others raise theirs.
What managed-care plans pay for Q4303
Most Medicaid members are in managed-care plans, and plans don't publish their provider fee schedules. For Q4303, the public signal is the rule each state sets for its plans, recorded on each rate above.
In 2 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 3 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 6 states is not classified yet.
- Plans negotiate; the published rate applies out of network (3 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 (2 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.
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 California managed care.
Units and billing for Q4303
Q4303 is a HCPCS Level II temporary code in the physician & professional line, billed mostly by physicians, nurse practitioners, physician assistants and other licensed practitioners. Q codes are temporary codes for drugs, biologicals, supplies and services. The unit depends on the code and is often a dose or an item.
Practitioners who are not physicians are often paid a reduced percentage of the published amount, so check the schedule for the reduction that applies to your provider type. Physician-fee-schedule codes are billed per service: one unit is one occurrence unless the code itself is defined by time or quantity.
Medicare's 2026 physician fee schedule pays $116.19–$183.51 for Q4303 (non-facility), depending on the Medicare locality. That is a useful reference point, but Medicare and Medicaid can define the unit differently, so compare only where the units match.
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.
Frequently asked questions
What does Medicaid pay for Q4303?
It depends on the state. Of the 11 states with a published fee-for-service rate, the median is $119.93. California pays the most ($3,412.79) and Indiana the least ($50.55 per unit).
Which state pays the highest Medicaid rate for Q4303?
California, at $3,412.79, effective 2026-10-01.
Which state pays the lowest Medicaid rate for Q4303?
Indiana, at $50.55 per unit, effective 2026-01-01. It publishes the code in a different unit from California, so compare per unit with care.
What unit is Q4303 billed in?
Of the 11 states, 1 publish Q4303 per unit, and 10 schedules print no unit at all (a flat amount per service).
Do managed-care plans pay the same rate for Q4303?
Not necessarily. In 2 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 3 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 6 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.