A4230 Medicaid reimbursement rates by state
Infusion set for external insulin pump. 38 state Medicaid programs publish a fee-for-service rate for A4230. Rates run from $0.01 in Missouri to $201.45 in Washington, with a median of $11.68.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 38
- Median rate
- $11.68units vary by state
- Highest
- $201.45Washington
- Medicare (non-facility)
- —not on the physician fee schedule
A4230 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 |
|---|---|---|---|---|---|---|
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $201.45⚠ over 3× mediansince 2021-01-01 | — | — | Plans negotiate; applies out of network | — | HCA Home infusion therapy/parenteral nut |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $166.87⚠ over 3× mediansince 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Durable Medical Equipment and Medical Su |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $115.50⚠ over 3× mediansince 2023-07-01 | — | — | State sets the plan rate | — | KY Medicaid DME fee schedule (2023Medica |
| IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $85.51⚠ over 3× mediansince 2024-07-01 | — | — | State sets the plan rate | — | Iowa Medicaid fee schedule #08 PHARMACY |
| District of ColumbiaAny qualified provider (rate does not vary by provider) · DC Medicaid (DHCF) fee-for-service | $25.00since 1997-04-01 | — | — | Not classified | — | REFRP00178CSV - Medical Fee Schedule Rep |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $20.46since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $16.00since 2016-07-01 | — | — | Plans negotiate; applies out of network | — | DME Fee Schedule - Excel.xlsx |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $15.51since 2024-07-01 | — | — | Not classified | — | SCDHHS Durable Medical Equipment (DME) F |
| New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service) | $15.20since 2022-06-01 | — | — | Plans negotiate; applies out of network | — | eMedNY NYS Medicaid DMEPOS Fee Schedule |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $15.02since 2025-10-01 | — | — | Plans negotiate; applies out of network | — | NC Medicaid fee schedule 'Durable Medica |
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services) | $14.90since 2026-07-01 | — | — | Not classified | — | South Dakota Medicaid DME fee schedule ( |
| AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules) | $14.80since 2026-05-20 | — | — | Not classified | — | EPSDT Referral (DME) Fee Schedule (REF-0 |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $14.35since 2006-08-01 | — | — | Not classified | — | CMAP fee schedule: 10/01/2026 MEDS - Med |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $14.12since 2026-01-01 | — | — | Not classified | — | MaineCare Section 60, Medical Supplies a |
| West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services) | $14.00since 2026-04-01 | — | — | Plans must pay at least this | — | BMS DME 2026 Rural Fee Schedule Effectiv |
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $13.43since 2022-07-01 | — | — | Not classified | — | Health First Colorado Physician Fee Sche |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $12.99since 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) | $12.68since 2025-09-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Dmepo |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $11.69since 2021-01-01 | — | — | Not classified | — | 2026 Fee Schedule - Covered Procedures R |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $11.66since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $11.15since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $10.60since 2023-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Medical Suppliers/Orthotists/Prost |
| North DakotaAny qualified provider (rate does not vary by provider) · North Dakota Medicaid (fee-for-service) | $10.56since 2026-07-01 | — | — | Not classified | — | ND Medicaid DME and Supplies Fee Schedul |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $10.38since 2008-07-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Supplies |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $10.31since 2010-07-01 | Each | — | Plans negotiate; applies out of network | — | DMAS procedure fee file hcpcmedical.csv |
| MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service) | $10.22since 2021-01-01 | — | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, June 202 |
| NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $10.00since 2011-08-01 | — | — | Plans negotiate; applies out of network | — | Provider Type 33, Durable Medical Equipm |
| UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan) | $9.98since 2010-07-01 | — | — | Plans negotiate; applies out of network | — | Utah Medicaid Coverage and Reimbursement |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $9.92since 2008-03-15 | — | — | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health) | $9.70since 2021-01-01 | — | — | Not classified | — | Wyoming Medicaid Downloadable Fee Schedu |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $9.53since 2020-08-01 | — | — | Plans must pay at least this | — | SoonerCare Durable Medical Equipment Rat |
| KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $9.21since 2005-10-01 | — | — | Paid by the state, outside plans | — | KMAP Fee Schedule MKN Medicaid (FeeSched |
| HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service | $9.06since 2024-03-04 | — | — | Plans negotiate; applies out of network | — | Medicaid Fee-For-Service (FFS) Fee Sched |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $8.66since 2007-03-29 | Set | — | Plans negotiate; applies out of network | — | ODM DMEPOS payment schedule (appendix to |
| VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA) | $7.81since 2023-03-01 | — | — | Not classified | — | Vermont Medicaid Fee Schedule - DME Code |
| AlaskaAny qualified provider (rate does not vary by provider) · Alaska Medicaid (fee-for-service, Department of Health) | $7.43since 2025-10-01 | — | — | Not classified | — | Alaska Medicaid DMEPOS Interim Fee Sched |
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service) | $6.44since 2025-06-04 | — | — | Not classified | — | Arkansas Medicaid Prosthetics (includes |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $0.01since 2004-01-01 | — | — | 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 A4230?
It depends on the state. Of the 38 states with a published fee-for-service rate, the median is $11.68. Washington pays the most ($201.45) and Missouri the least ($0.01).
Which state pays the highest Medicaid rate for A4230?
Washington, at $201.45, effective 2021-01-01.
Do managed-care plans pay the same rate for A4230?
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.
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Track A4230 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.