A0426 Medicaid reimbursement rate by state (2026)

• Order. States are listed from the highest published rate to the lowest. No single unit is shared by 8 or more states for A0426, so the order is by published amount and is not a like-for-like rank.
• Medicaid rate. The most the state's fee-for-service program pays for one unit, as published. 15 of the 42 states list more than one rate for A0426, by modifier, provider type or setting; the table shows the one that matches the provider level and setting used across states, without add-ons.
• Unit. Of the 42 states, 1 publish A0426 per unit, and 41 schedules print no unit at all (a flat amount per service).
• Per hour. A0426 is not billed in time units in these states, so no hourly figure is shown.
• Managed-care plans. The rule the state sets for its plans on this rate. What each rule means is explained below.
• % of Medicare. No Medicare physician fee schedule amount is on file for A0426, so there is no percentage.
• Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.

Published rates for A0426 run from $69.95 in Rhode Island to $845.14 in Arizona, a 12.1x gap in the same unit. Half the states pay more than the median of $253.19 and half pay less. The usual reasons for a spread like this in transportation rates:

• Emergency and non-emergency trips, advanced and basic life support, and urban and rural trips can each carry their own rates.
• Many states run non-emergency medical transportation through a broker, so the state fee schedule covers only part of the benefit.
• Ambulance payment is usually a base rate per transport plus mileage, and states weight the two differently.

Timing matters too. 12 states set the current rate for A0426 in 2026 or later, while 12 states still pay a rate that took effect in 2022 or earlier. A state that has not updated its rate in years will drift down the ranking as others raise theirs.

What a plan pays for A0426 is negotiated privately, but the state decides how much room there is to negotiate. Here is how the rules break down across the 42 states.

In 10 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 14 states, plans negotiate and the published rate is a benchmark or out-of-network default. In 5 states, the service is paid outside the plans or through a state-directed payment. The rule for the remaining 13 states is not classified yet.

• Plans negotiate; the published rate applies out of network (14 states). In-network rates can be above or below the published rate. The published rate is the benchmark both sides know, and the fallback if no contract is signed.
• Plans must pay at least the published rate (10 states). The published rate is your floor. Negotiate up from it, and if a plan pays less, the contract provision is the basis for a payment dispute.
• Paid by the state, outside the plans (5 states). Bill the state's Medicaid program, not the plan, at the published rate. There is no plan contract to negotiate for this service.

Plan-negotiated rates are never estimated here. To see the rule and its citation for a particular state, open that state's managed-care page, for example Arizona managed care.

A0426 is a HCPCS Level II transportation and supply code in the transportation line, billed mostly by ambulance services and non-emergency transportation providers. A codes cover ambulance and transportation services and medical and surgical supplies. Transport codes are paid per trip or per mile; supply codes per item or per box as the code states.

The base rate is billed once per trip and mileage per loaded mile under its own code. Origin and destination modifiers on the claim identify where the trip started and ended.

Before billing, confirm the rate, unit and any modifier with the state's current schedule or the plan: the amounts here are as published, not a guarantee of payment.