S9367 Medicaid reimbursement rate by state (2026)
Home infusion therapy, total parenteral nutrition (tpn). Medicaid pays a median of $141.00 per day for S9367 across 9 states, from $43.95 in Massachusetts to $358.49 in Montana.
- States publishing
- 9
- National median
- $141.00per day
- Lowest
- $43.95Massachusetts
- Highest
- $358.49Montana
What does Medicaid pay for S9367?
9 state Medicaid programs publish a fee-for-service rate for S9367. The national median is $141.00 per day. Montana pays the most, $358.49 per day, and Massachusetts the least, $43.95 per day, a 8.2x spread.
S9367 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 9 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. A like-for-like rank only counts states that use the same unit: 9 of the 9 states publish S9367 per day, enough to rank them against each other.
- Medicaid rate. The most the state's fee-for-service program pays for one unit, as published. 2 of the 9 states list more than one rate for S9367, 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. All 9 states publish S9367 per day, so the amounts compare directly.
- Per hour. S9367 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. No Medicare physician fee schedule amount is on file for S9367, so there is no percentage.
- Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.
Why S9367 rates differ between states
Published rates for S9367 run from $43.95 in Massachusetts to $358.49 in Montana, a 8.2x gap in the same unit. Half the states pay more than the median of $141.00 per day and half pay less. The usual reasons for a spread like this in equipment & supplies rates:
- Some items are priced individually from the manufacturer's price or the supplier's invoice, so fewer states publish a fixed fee.
- Many states set equipment and supply fees as a percentage of the Medicare DMEPOS fee schedule, at different percentages and from different years.
- A single code can carry separate purchase, rental and used-equipment amounts, and states publish different subsets of them.
Timing matters too. 2 states set the current rate for S9367 in 2026 or later, while 5 states still pay a rate that took effect in 2022 or earlier. 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 S9367
Most Medicaid members are in managed-care plans, and plans don't publish their provider fee schedules. For S9367, the public signal is the rule each state sets for its plans, recorded on each rate above.
In 1 state, the published rate binds plans: a floor, a pass-through or a state-set rate. In 5 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 3 states is not classified yet.
- Plans negotiate; the published rate applies out of network (5 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.
- The state sets the plan rate (1 state). There is little to negotiate on price. Contracting is about network participation, authorization and billing terms.
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 Montana managed care.
Units and billing for S9367
S9367 is a HCPCS Level II temporary national code in the equipment & supplies line, billed mostly by durable medical equipment suppliers, orthotists, prosthetists and pharmacies. S codes were created for private payers and are widely used by Medicaid programs for services Medicare does not cover, such as home nursing and home infusion. Units range from 15 minutes to a day.
Pricing modifiers decide which amount applies: NU for a new purchase, RR for a monthly rental and UE for used equipment. Units follow the code: per item, per pair, per box or per month of rental, so a per-unit comparison only holds when the states use the same unit.
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 S9367?
It depends on the state. Of the 9 states with a published fee-for-service rate, the median is $141.00 per day. Montana pays the most ($358.49 per day) and Massachusetts the least ($43.95 per day).
Which state pays the highest Medicaid rate for S9367?
Montana, at $358.49 per day, effective 2025-07-01.
Which state pays the lowest Medicaid rate for S9367?
Massachusetts, at $43.95 per day, effective 2026-03-01.
What unit is S9367 billed in?
All 9 states publish S9367 per day, so the amounts compare directly.
Do managed-care plans pay the same rate for S9367?
Not necessarily. In 1 state, the published rate binds plans: a floor, a pass-through or a state-set rate. In 5 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 3 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.