A4238 Medicaid reimbursement rates by state
Supply allowance for adjunctive. 29 state Medicaid programs publish a fee-for-service rate for A4238. Rates run from $185.98 in South Carolina to $841.59 in Colorado, with a median of $261.95.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 29
- Median rate
- $261.95units vary by state
- Highest
- $841.59Colorado
- Medicare (non-facility)
- —not on the physician fee schedule
A4238 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 |
|---|---|---|---|---|---|---|
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $841.59⚠ over 3× mediansince 2025-10-01 | — | — | Not classified | — | Health First Colorado Physician Fee Sche |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $335.00since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Durable |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $280.71since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service) | $280.71since 2026-06-09 | — | — | Not classified | — | Arkansas Medicaid Prosthetics (includes |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $280.71since 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) | $280.71since 2026-01-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP) | $280.71since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | DMAP 2026 DME Fee Schedule |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $275.21since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $270.89since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | HCA Home infusion therapy/parenteral nut |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $268.76since 2026-03-01 | — | — | Plans negotiate; applies out of network | — | Rates for Durable Medical Equipment, Oxy |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $268.76since 2024-05-15 | — | — | State sets the plan rate | — | KY Medicaid DME fee schedule (2024Medica |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $261.95since 2023-04-01 | — | — | Plans negotiate; applies out of network | — | Copy of Durable Medical Equipment Servic |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $261.95since 2025-10-01 | — | — | Plans negotiate; applies out of network | — | NC Medicaid fee schedule 'Durable Medica |
| TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP) | $261.95since 2023-01-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Dmepo |
| New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service) | $261.95since 2023-04-01 | — | — | Plans negotiate; applies out of network | — | eMedNY NYS Medicaid DMEPOS Fee Schedule |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $261.95since 2022-04-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $259.01since 2024-07-01 | — | — | State sets the plan rate | — | Iowa Medicaid fee schedule #08 PHARMACY |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $252.64since 2026-01-01 | 1 unit =1 month | — | Plans must pay at least this | — | DMAS procedure fee file hcpcmedical.csv |
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services) | $251.16since 2026-07-01 | — | — | Not classified | — | South Dakota Medicaid DME fee schedule ( |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $248.19since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $238.60since 2026-01-01 | — | — | Not classified | — | Maryland Medicaid DME/DMS/Oxygen, Prosth |
| KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $224.57since 2026-07-01 | — | — | Paid by the state, outside plans | — | KMAP Fee Schedule MKN Medicaid (FeeSched |
| MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service) | $224.57since 2026-07-01 | — | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, Septembe |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $215.01since 2025-01-01 | — | — | Not classified | — | 2026 Fee Schedule - Covered Procedures R |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $210.00since 2024-01-01 | Each | — | Plans negotiate; applies out of network | — | ODM DMEPOS combined payment schedules (a |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $209.56since 2023-09-05 | — | — | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $207.24since 2023-06-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Medical Suppliers/Orthotists/Prost |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $196.50since 2026-07-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $185.98since 2022-04-01 | — | — | Not classified | — | SCDHHS Durable Medical Equipment (DME) F |
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 A4238?
It depends on the state. Of the 29 states with a published fee-for-service rate, the median is $261.95. Colorado pays the most ($841.59) and South Carolina the least ($185.98).
Which state pays the highest Medicaid rate for A4238?
Colorado, at $841.59, effective 2025-10-01.
Do managed-care plans pay the same rate for A4238?
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
L0120Cervical, flexible, non-adjustable, prefabricated · 48 statesL0130Cervical, flexible, thermoplastic collar, molded to patient · 48 statesL0140Cervical, semi-rigid, adjustable (plastic collar) · 48 statesL0150Cervical, semi-rigid, adjustable molded chin cup · 48 statesL0172Cervical, collar, semi-rigid thermoplastic foam, two-piece · 48 statesL0174Cervical, collar, semi-rigid, thermoplastic foam · 48 statesL0200Cervical, multiple post collar · 48 statesL0220Thoracic, rib belt, custom fabricated · 48 statesL0450Tlso, flexible, provides trunk support · 48 statesL0472Tlso, triplanar control, hyperextension · 48 statesL0482Tlso, triplanar control · 48 statesL0484Tlso, triplanar control · 48 states
Track A4238 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.