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T2101 Medicaid reimbursement rates by state

Human breast milk processing, storage and distribution only. 12 state Medicaid programs publish a fee-for-service rate for T2101 at the physician psychologist level. Rates run from $3.00 in Pennsylvania to $7.37 in Indiana, with a median of $4.55.

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

States publishing
12
Median rate
$4.55units vary by state
Highest
$7.37Indiana
Medicare (non-facility)
—not on the physician fee schedule

T2101 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
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$7.37since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$5.81since 2026-01-01——Not classified—MaineCare Section 60, Medical Supplies a
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$5.53since 2020-08-20——Plans must pay at least this—Louisiana Medicaid Durable Medical Equip
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$4.75since 2018-07-16Ounce—Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$4.66since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$4.59since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$4.50since 2024-10-01——Plans negotiate; applies out of network—AHCCCS Arizona Health Care Cost Containm
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$4.50since 2019-01-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$4.38since 2020-09-25——Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2020-09-
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$4.29since 2024-01-01——Plans must pay at least this—SoonerCare Title XIX Fee Schedule
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$3.00since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$3.00since 2017-08-07——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (

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 T2101?

It depends on the state. Of the 12 states with a published fee-for-service rate, the median is $4.55. Indiana pays the most ($7.37 per unit) and Pennsylvania the least ($3.00).

Which state pays the highest Medicaid rate for T2101?

Indiana, at $7.37 per unit, effective 2026-01-01.

Do managed-care plans pay the same rate for T2101?

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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