Billing code T4537 · Equipment & supplies

T4537 Medicaid reimbursement rate by state (2026)

Incontinence product, protective underpad, reusable. Medicaid pays a median of $13.54 for T4537 across 22 states, from $0.40 in Washington to $22.00 in Indiana.

Data as of Oct 5, 202622 statesEvery rate links to its official source

Compare T4537 in all 22 states All billing codes

States publishing: 22
National median: $13.54units vary by state
Lowest: $0.40Washington
Highest: $22.00Indiana

Answer

What does Medicaid pay for T4537?

22 state Medicaid programs publish a fee-for-service rate for T4537. The national median is $13.54 (units differ between states). Indiana pays the most, $22.00 per unit, and Washington the least, $0.40, a 55.0x spread.

State ranking

T4537 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 22 states with every variant, modifier and effective date.

#	State	Medicaid rate	Unit	Per hour	Managed-care plans	% of Medicare
1	Indiana Source · since 2014-01-01	$22.00	unit	—	Plans must pay at least this	—
2	Kentucky Source · since 2023-09-15	$21.00	—	—	State sets the plan rate	—
3	Ohio Source · since 2005-01-01	$20.00	Each	—	Plans negotiate; applies out of network	—
···
11	New York Source · since 2022-06-01	$13.57	—	—	Plans negotiate; applies out of network	—
12	Idaho Source · since 2025-09-01	$13.51	—	—	Not classified	—
13	Oklahoma Source · since 2024-10-01	$13.50	unit	—	Paid by the state, outside plans	—
···
21	Connecticut Source · since 2005-03-01	$4.25	—	—	Not classified	—
22	Washington Source · since 2021-01-01	$0.40	—	—	Plans negotiate; applies out of network	—

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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.

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FAQ

Frequently asked questions

What does Medicaid pay for T4537?

It depends on the state. Of the 22 states with a published fee-for-service rate, the median is $13.54. Indiana pays the most ($22.00 per unit) and Washington the least ($0.40).

Which state pays the highest Medicaid rate for T4537?

Indiana, at $22.00 per unit, effective 2014-01-01.

Do managed-care plans pay the same rate for T4537?

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.

T4537 Medicaid reimbursement rate by state (2026)

What does Medicaid pay for T4537?

T4537 rate by state: highest, middle and lowest

Frequently asked questions

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