S9500 Medicaid reimbursement rates by state
Home infusion therapy, antibiotic, antiviral. 12 state Medicaid programs publish a fee-for-service rate for S9500. Rates run from $9.27 in Illinois to $149.77 in Montana, with a median of $47.50.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 12
- Median rate
- $47.50per day
- Highest
- $149.77Montana
- Medicare (non-facility)
- —not on the physician fee schedule
S9500 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 |
|---|---|---|---|---|---|---|
| MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service) | $149.77since 2025-07-01 | day | — | Not classified | — | Montana Healthcare Programs fee schedule |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $96.58since 2012-01-01 | day | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $87.19since 2011-08-01 | day | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $79.56since 2026-04-01 | day | — | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
| VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA) | $73.50since 2023-03-01 | day | — | Not classified | — | Vermont Medicaid Fee Schedule - DME Code |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $50.00since 2022-01-01 | day | — | State sets the plan rate | — | KY Medicaid DME fee schedule (2022Medica |
| AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules) | $45.00since 2026-05-27 | day | — | Not classified | — | DME/POP Fee Schedule (REF-0132-Q) |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $44.86since 2026-03-01 | day | — | Plans negotiate; applies out of network | — | Rates for Durable Medical Equipment, Oxy |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $44.08since 2023-01-01 | day | — | Plans negotiate; applies out of network | — | MDHHS Medical Suppliers/Orthotists/Prost |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $30.27since 2024-07-01 | day | — | Not classified | — | SCDHHS Durable Medical Equipment (DME) F |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $27.00since 2004-01-01 | day | — | Plans negotiate; applies out of network | — | DMAS procedure fee file hcpcmedical.csv |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $9.27since 2024-01-01 | day | — | Plans negotiate; applies out of network | — | HFS DME Fee Schedule (effective 2024-01- |
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 S9500?
It depends on the state. Of the 12 states with a published fee-for-service rate, the median is $47.50 per day. Montana pays the most ($149.77 per day) and Illinois the least ($9.27 per day).
Which state pays the highest Medicaid rate for S9500?
Montana, at $149.77 per day, effective 2025-07-01.
Do managed-care plans pay the same rate for S9500?
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.