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A4310 Medicaid reimbursement rates by state

Insertion tray without drainage bag and without catheter. 37 state Medicaid programs publish a fee-for-service rate for A4310 at the agency level. Rates run from $2.15 in New York to $15.81 in New Mexico, with a median of $7.49.

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

States publishing
37
Median rate
$7.49units vary by state
Highest
$15.81New Mexico
Medicare (non-facility)
—not on the physician fee schedule

A4310 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 MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$15.81since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$11.81since 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)$11.01since 2026-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$11.01since 2026-01-01——Plans must pay at least this—SoonerCare Durable Medical Equipment Rat
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$11.01since 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)$9.97since 2026-01-01——Not classified—Montana Healthcare Programs fee schedule
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$9.91since 2026-01-01Each—Plans must pay at least this—DMAS procedure fee file hcpcmedical.csv
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$8.96since 2026-03-01——Plans negotiate; applies out of network—Rates for Durable Medical Equipment, Oxy
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$8.92since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$8.81since 2026-04-01——Plans must pay at least this—BMS DME 2026 Rural Fee Schedule Effectiv
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$8.66since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$8.54since 2017-01-01——Plans negotiate; applies out of network—Provider Type 33, Durable Medical Equipm
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$8.43since 2026-07-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$8.27since 2021-01-01——Plans negotiate; applies out of network—HCA Medical equipment and supplies fee s
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$8.08since 2026-07-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$7.96since 2022-10-17——Plans negotiate; applies out of network—MO HealthNet fee schedule: Durable Medic
IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$7.80since 2024-07-01——State sets the plan rate—Iowa Medicaid fee schedule #08 PHARMACY
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$7.56since 2024-07-01——Not classified—SCDHHS Durable Medical Equipment (DME) F
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$7.49since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$7.42since 2022-01-01——Plans negotiate; applies out of network—KY Medicaid Home Health fee schedule (20
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$7.35since 2024-01-01——Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2024-01-
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$7.33since 2022-07-01——Not classified—Health First Colorado Physician Fee Sche
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$7.17since 2024-10-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$7.13since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$6.75since 2025-10-01each—Plans negotiate; applies out of network—NC Medicaid fee schedule 'Home Health Se
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$6.56since 2007-05-01——Not classified—CMAP fee schedule: 10/01/2026 MEDS - Med
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$6.13since 2016-07-01——Plans negotiate; applies out of network—DME Fee Schedule - Excel.xlsx
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$6.11since 2014-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$5.90since 2025-05-16——Not classified—Arkansas Medicaid Home Health Fee Schedu
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$5.47since 1997-07-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Dmepo
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$5.12since 2023-01-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$4.92since 2008-07-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Supplies
FloridaAny qualified provider (rate does not vary by provider) · Florida iBudget waiver for people with developmental disabilities (APD)$4.51since 2026-07-01Item—Paid by the state, outside plans—Florida Medicaid Developmental Disabilit
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$4.40since 1996-01-01——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$3.90since 1990-05-01Each—Plans negotiate; applies out of network—ODM DMEPOS payment schedule (appendix to
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$3.71since 2012-07-01——Plans must pay at least this—Louisiana Medicaid Durable Medical Equip
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$2.15since 2022-06-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule

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 A4310?

It depends on the state. Of the 37 states with a published fee-for-service rate, the median is $7.49. New Mexico pays the most ($15.81) and New York the least ($2.15).

Which state pays the highest Medicaid rate for A4310?

New Mexico, at $15.81, effective 2025-01-01.

Do managed-care plans pay the same rate for A4310?

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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