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A4311 Medicaid reimbursement rates by state

Insertion tray without drainage bag with indwelling.... 29 state Medicaid programs publish a fee-for-service rate for A4311 at the nurse midwife level. Rates run from $4.46 in Florida to $22.45 in Arizona, with a median of $13.74.

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

States publishing
29
Median rate
$13.74units vary by state
Highest
$22.45Arizona
Medicare (non-facility)
—not on the physician fee schedule

A4311 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
ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$22.45since 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)$21.11since 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)$21.11since 2026-01-01——Plans must pay at least this—SoonerCare Durable Medical Equipment Rat
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$17.06since 2024-07-01——Not classified—SCDHHS Durable Medical Equipment (DME) F
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$16.22since 2022-01-01——Plans negotiate; applies out of network—KY Medicaid Home Health fee schedule (20
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$16.20since 2026-03-01——Plans negotiate; applies out of network—Rates for Durable Medical Equipment, Oxy
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$16.15since 2026-01-01Each—Plans must pay at least this—DMAS procedure fee file hcpcmedical.csv
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$16.01since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$15.88since 2021-01-01——Plans negotiate; applies out of network—HCA Medical equipment and supplies fee s
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$15.27since 2025-10-01each—Plans negotiate; applies out of network—NC Medicaid fee schedule 'Home Health Se
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$15.25since 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)$14.35since 2026-07-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$14.19since 2025-05-16——Not classified—Arkansas Medicaid Home Health Fee Schedu
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$14.12since 2024-01-01——Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2024-01-
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$13.74since 2024-10-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$13.11since 2023-01-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$12.99since 2022-10-17——Plans negotiate; applies out of network—MO HealthNet fee schedule: Durable Medic
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$12.90since 2022-07-01——Not classified—Health First Colorado Physician Fee Sche
IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$12.76since 2024-07-01——State sets the plan rate—Iowa Medicaid fee schedule #08 PHARMACY
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$12.61since 1996-01-01——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$12.61since 2007-05-01——Not classified—CMAP fee schedule: 10/01/2026 MEDS - Med
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$12.56since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$11.74since 2014-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$11.48since 2008-07-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Supplies
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$10.72since 1997-07-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Dmepo
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$10.24since 2012-07-01——Plans must pay at least this—Louisiana Medicaid Durable Medical Equip
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$6.75since 1990-05-01Each—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)$6.00since 2022-06-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
FloridaAny qualified provider (rate does not vary by provider) · Florida iBudget waiver for people with developmental disabilities (APD)$4.46since 2015-10-19——Paid by the state, outside plans—Developmental Disabilities Individual Bu

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 A4311?

It depends on the state. Of the 29 states with a published fee-for-service rate, the median is $13.74. Arizona pays the most ($22.45) and Florida the least ($4.46).

Which state pays the highest Medicaid rate for A4311?

Arizona, at $22.45, effective 2026-10-01.

Do managed-care plans pay the same rate for A4311?

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

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