S5561 Medicaid reimbursement rates by state
Insulin delivery device, reusable pen; 3 ml size. 6 state Medicaid programs publish a fee-for-service rate for S5561 at the physician psychologist level. Rates run from $15.03 in Kansas to $59.53 in New Hampshire, with a median of $30.42.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 6
- Median rate
- $30.42units vary by state
- Highest
- $59.53New Hampshire
- Medicare (non-facility)
- —not on the physician fee schedule
S5561 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 |
|---|---|---|---|---|---|---|
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $59.53since 2021-01-01 | — | — | Plans negotiate; applies out of network | — | 2026 Fee Schedule - Covered Procedures R |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $55.81since 2025-10-01 | — | — | Plans negotiate; applies out of network | — | NC Medicaid fee schedule 'Durable Medica |
| New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service) | $30.97since 2024-04-01 | — | — | Plans negotiate; applies out of network | — | eMedNY NYS Medicaid DMEPOS Fee Schedule |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $29.86since 2020-08-01 | — | — | Plans must pay at least this | — | SoonerCare Durable Medical Equipment Rat |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $22.14since 2026-02-01 | — | — | Plans must pay at least this | — | Physician Administered Drug (PAD) Pricin |
| KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $15.03since 2005-10-01 | — | — | Paid by the state, outside plans | — | KMAP Fee Schedule MKN Medicaid (FeeSched |
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 S5561?
It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $30.42. New Hampshire pays the most ($59.53) and Kansas the least ($15.03).
Which state pays the highest Medicaid rate for S5561?
New Hampshire, at $59.53, effective 2021-01-01.
Do managed-care plans pay the same rate for S5561?
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.