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A4217 Medicaid reimbursement rates by state

Sterile water/saline, 500 ml. 41 state Medicaid programs publish a fee-for-service rate for A4217 at the nurse midwife level. Rates run from $1.32 in Iowa to $16.64 in New Hampshire, with a median of $3.13.

Data as of 2026-10-05. Every rate links to the official document it came from.

States publishing
41
Median rate
$3.13units vary by state
Highest
$16.64New Hampshire
Medicare (non-facility)
—not on the physician fee schedule

A4217 rate in every state

One like-for-like fee-for-service rate per state, highest first. Units can differ between states; the per-hour column converts time-based units.

StateMedicaid rateUnitPer hourManaged-care plans% of MedicareSource
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$16.64⚠ over 3× mediansince 2021-01-01——Not classified—2026 Fee Schedule - Covered Procedures R
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$6.42since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$6.00since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$4.80since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$4.67since 2025-05-16——Not classified—Arkansas Medicaid Home Health Fee Schedu
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$4.47since 2026-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP)$4.47since 2026-01-01——Plans negotiate; applies out of network—DMAP 2026 Physician Fee Schedule
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$3.86since 2026-01-01——Plans must pay at least this—SoonerCare Durable Medical Equipment Rat
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$3.80since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$3.80since 2026-01-01——Not classified—MaineCare Section 60, Medical Supplies a
MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service)$3.80since 2026-01-01——Not classified—Montana Healthcare Programs fee schedule
HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service$3.78since 2026-06-01——Plans negotiate; applies out of network—Medicaid Fee-For-Service (FFS) Fee Sched
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$3.66since 2025-01-01——Not classified—Vermont Medicaid Fee Schedule - DME Code
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$3.64since 2026-01-01Each—Plans must pay at least this—DMAS procedure fee file hcpcmedical.csv
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$3.58since 2026-04-01——Plans must pay at least this—BMS DME 2026 Rural Fee Schedule Effectiv
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$3.42since 2024-10-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$3.38since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$3.36since 2021-07-01——Plans negotiate; applies out of network—HCA Respiratory care fee schedule (respi
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$3.28since 2026-07-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$3.22since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$3.13since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$3.13since 2008-03-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Dmepo
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$3.09since 2026-03-01——Plans negotiate; applies out of network—Rates for Durable Medical Equipment, Oxy
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$3.07since 2024-07-01——Not classified—SCDHHS Durable Medical Equipment (DME) F
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$3.04since 2026-07-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$3.02since 2025-01-01——Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2025-01-
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$2.92since 2021-07-01——Not classified—Health First Colorado Physician Fee Sche
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$2.92since 2022-01-01——Plans negotiate; applies out of network—KY Medicaid Home Health fee schedule (20
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$2.74since 2019-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Durable Medic
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$2.72since 2025-07-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$2.66since 2007-05-01——Not classified—CMAP fee schedule: 10/01/2026 MEDS - Med
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$2.64since 2025-10-01——Plans must pay at least this—NC Medicaid fee schedule 'Nurse Midwives
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$2.61since 2026-07-01——Plans negotiate; applies out of network—Durable Medical Equipment and Medical Su
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$2.50since 2007-10-06500-milliliter bottle—Plans negotiate; applies out of network—ODM DMEPOS payment schedule (appendix to
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$2.50since 2016-07-01——Plans negotiate; applies out of network—DME Fee Schedule - Excel.xlsx
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$2.50since 2005-02-07——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service)$2.45since 2012-07-01——Plans negotiate; applies out of network—RI Medicaid Interactive Fee For Service
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$1.87since 2026-05-27——Not classified—DME/POP Fee Schedule (REF-0132-Q)
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$1.86since 2008-07-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Supplies
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$1.60since 2022-06-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$1.32since 2024-07-01——State sets the plan rate—Iowa Medicaid fee schedule #08 PHARMACY

Rates marked ⚠ are more than three times the median for the same unit; they are published as shown but often reflect an office (non-facility) fee or a different scope of service. 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 with the CMS formula; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Frequently asked questions

What does Medicaid pay for A4217?

It depends on the state. Of the 41 states with a published fee-for-service rate, the median is $3.13. New Hampshire pays the most ($16.64) and Iowa the least ($1.32).

Which state pays the highest Medicaid rate for A4217?

New Hampshire, at $16.64, effective 2021-01-01.

Do managed-care plans pay the same rate for A4217?

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 table shows the rule for each state, cited to the contract or statute.

Related Equipment & supplies codes

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