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Billing code T4526 · Equipment & supplies

T4526 Medicaid reimbursement rate by state (2026)

Adult sized disposable incontinence product. Medicaid pays a median of $0.78 for T4526 across 41 states, from $0.45 in Vermont to $1.47 in Indiana.

Data as of Oct 5, 202641 statesEvery rate links to its official source

States publishing
41
National median
$0.78units vary by state
Lowest
$0.45Vermont
Highest
$1.47Indiana
Answer

What does Medicaid pay for T4526?

41 state Medicaid programs publish a fee-for-service rate for T4526. The national median is $0.78 (units differ between states). Indiana pays the most, $1.47 per unit, and Vermont the least, $0.45, a 3.3x spread.

State ranking

T4526 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.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Indiana Source · since 2014-01-01$1.47unit—Plans must pay at least this—
2Michigan Source · since 2023-01-01$1.42——Plans negotiate; applies out of network—
3Wyoming Source · since 2022-05-01$1.09——Not classified—
20Rhode Island Source · since 2015-06-01$0.79——Plans negotiate; applies out of network—
21North Carolina Source · since 2025-10-01$0.78——Plans negotiate; applies out of network—
22Mississippi Source · since 2022-10-01$0.75——Plans must pay at least this—
40Delaware Source · since 2024-01-01$0.50——Plans negotiate; applies out of network—
41Vermont Source · since 2023-08-15$0.45——Not classified—
See all 41 states for T4526 — start free

33 more states, with every modifier and provider-type variant, rate history and the plan rule in each state. 14-day free trial, no credit card.

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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; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Track T4526 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
FAQ

Frequently asked questions

What does Medicaid pay for T4526?

It depends on the state. Of the 41 states with a published fee-for-service rate, the median is $0.78. Indiana pays the most ($1.47 per unit) and Vermont the least ($0.45).

Which state pays the highest Medicaid rate for T4526?

Indiana, at $1.47 per unit, effective 2014-01-01.

Do managed-care plans pay the same rate for T4526?

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.