A4223 Medicaid reimbursement rates by state
Infusion supplies not used with external infusion pump. 16 state Medicaid programs publish a fee-for-service rate for A4223. Rates run from $0.01 in Missouri to $63.15 in Nebraska, with a median of $12.55.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 16
- Median rate
- $12.55units vary by state
- Highest
- $63.15Nebraska
- Medicare (non-facility)
- —not on the physician fee schedule
A4223 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.
| State | Medicaid rate | Unit | Per hour | Managed-care plans | % of Medicare | Source |
|---|---|---|---|---|---|---|
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $63.15⚠ over 3× mediansince 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $58.24⚠ over 3× mediansince 2018-01-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $49.54⚠ over 3× mediansince 2025-01-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service HCPC |
| NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $43.86⚠ over 3× mediansince 2012-12-01 | — | — | Plans negotiate; applies out of network | — | Provider Type 33, Durable Medical Equipm |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $36.90⚠ over 3× mediansince 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Durable Medical Equipment and Medical Su |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $16.84since 2024-01-01 | — | — | Plans negotiate; applies out of network | — | HFS DME Fee Schedule (effective 2024-01- |
| TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP) | $16.16since 2025-09-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Dmepo |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $15.00since 2007-03-21 | Set | — | Plans negotiate; applies out of network | — | ODM DMEPOS combined payment schedules (a |
| New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service) | $10.10since 2022-06-01 | — | — | Plans negotiate; applies out of network | — | eMedNY NYS Medicaid DMEPOS Fee Schedule |
| KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $10.00since 2007-09-01 | — | — | Paid by the state, outside plans | — | KMAP Fee Schedule MKN Medicaid (FeeSched |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $7.38since 2020-01-01 | — | — | Not classified | — | Maryland Medicaid DME/DMS/Oxygen, Prosth |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $6.70since 2016-07-01 | — | — | Plans negotiate; applies out of network | — | DME Fee Schedule - Excel.xlsx |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $6.50since 2020-08-01 | — | — | Plans must pay at least this | — | SoonerCare Durable Medical Equipment Rat |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $4.83since 2020-01-01 | — | — | State sets the plan rate | — | KY Medicaid DME fee schedule (2020Medica |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $1.38since 2021-01-01 | — | — | Plans negotiate; applies out of network | — | HCA Home infusion therapy/parenteral nut |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $0.01since 2005-01-01 | — | — | Plans negotiate; applies out of network | — | MO HealthNet fee schedule: Home Health |
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 A4223?
It depends on the state. Of the 16 states with a published fee-for-service rate, the median is $12.55. Nebraska pays the most ($63.15) and Missouri the least ($0.01).
Which state pays the highest Medicaid rate for A4223?
Nebraska, at $63.15, effective 2026-07-01.
Do managed-care plans pay the same rate for A4223?
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.