T4525 Medicaid reimbursement rate by state (2026)
Adult sized disposable incontinence product. Medicaid pays a median of $0.70 for T4525 across 41 states, from $0.45 in Vermont to $1.47 in Indiana.
- States publishing
- 41
- National median
- $0.70units vary by state
- Lowest
- $0.45Vermont
- Highest
- $1.47Indiana
What does Medicaid pay for T4525?
41 state Medicaid programs publish a fee-for-service rate for T4525. The national median is $0.70 (units differ between states). Indiana pays the most, $1.47 per unit, and Vermont the least, $0.45, a 3.3x spread.
T4525 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 41 states with every variant, modifier and effective date.
Frequently asked questions
What does Medicaid pay for T4525?
It depends on the state. Of the 41 states with a published fee-for-service rate, the median is $0.70. Indiana pays the most ($1.47 per unit) and Vermont the least ($0.45).
Which state pays the highest Medicaid rate for T4525?
Indiana, at $1.47 per unit, effective 2014-01-01.
Do managed-care plans pay the same rate for T4525?
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 workspace shows the rule for each state, cited to the contract or statute.