A4290 Medicaid reimbursement rates by state
Sacral nerve stimulation test lead, each. 6 state Medicaid programs publish a fee-for-service rate for A4290 at the physician psychologist level. Rates run from $27.21 in Kansas to $490.36 in Texas, with a median of $136.28.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 6
- Median rate
- $136.28units vary by state
- Highest
- $490.36Texas
- Medicare (non-facility)
- —not on the physician fee schedule
A4290 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 |
|---|---|---|---|---|---|---|
| TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP) | $490.36⚠ over 3× mediansince 2017-04-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Dmepo |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $139.81since 2014-10-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $139.59since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $132.96since 2021-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Durable |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $95.46since 2026-01-01 | — | — | Not classified | — | MaineCare Section 60, Medical Supplies a |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $27.21since 2001-01-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
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 A4290?
It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $136.28. Texas pays the most ($490.36) and Kansas the least ($27.21).
Which state pays the highest Medicaid rate for A4290?
Texas, at $490.36, effective 2017-04-01.
Do managed-care plans pay the same rate for A4290?
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.