T4536 Medicaid reimbursement rate by state (2026)
Incontinence product, protective underwear/pull-on. Medicaid pays a median of $7.69 for T4536 across 17 states, from $0.67 in Washington to $12.95 in Indiana.
- States publishing
- 17
- National median
- $7.69units vary by state
- Lowest
- $0.67Washington
- Highest
- $12.95Indiana
What does Medicaid pay for T4536?
17 state Medicaid programs publish a fee-for-service rate for T4536. The national median is $7.69 (units differ between states). Indiana pays the most, $12.95 per unit, and Washington the least, $0.67, a 19.3x spread.
T4536 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 17 states with every variant, modifier and effective date.
Frequently asked questions
What does Medicaid pay for T4536?
It depends on the state. Of the 17 states with a published fee-for-service rate, the median is $7.69. Indiana pays the most ($12.95 per unit) and Washington the least ($0.67).
Which state pays the highest Medicaid rate for T4536?
Indiana, at $12.95 per unit, effective 2014-01-01.
Do managed-care plans pay the same rate for T4536?
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.