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A4338 Medicaid reimbursement rates by state

Indwelling catheter; foley type, two-way latex with coating. 23 state Medicaid programs publish a fee-for-service rate for A4338 at the agency level. Rates run from $1.35 in New York to $18.77 in Arizona, with a median of $11.18.

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

States publishing
23
Median rate
$11.18units vary by state
Highest
$18.77Arizona
Medicare (non-facility)
—not on the physician fee schedule

A4338 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)$18.77since 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)$17.48since 2026-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$15.73since 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)$15.29since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$14.23since 2026-03-01——Plans negotiate; applies out of network—Rates for Durable Medical Equipment, Oxy
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$14.12since 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)$13.41since 2022-01-01——Plans negotiate; applies out of network—KY Medicaid Home Health fee schedule (20
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$13.13since 2021-01-01——Plans negotiate; applies out of network—HCA Medical equipment and supplies fee s
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$12.78since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$12.63since 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)$11.65since 2022-07-01——Not classified—Health First Colorado Physician Fee Sche
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$11.18since 2025-10-01each—Plans negotiate; applies out of network—NC Medicaid fee schedule 'Home Health Se
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$11.12since 2024-01-01——Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2024-01-
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$10.83since 2023-01-01——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)$10.52since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$10.44since 1997-07-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Dmepo
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$9.70since 2014-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$8.14since 1991-01-01——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$7.89since 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)$6.91since 2026-07-01Item—Paid by the state, outside plans—Florida Medicaid Developmental Disabilit
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$6.53since 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)$4.20since 1990-05-01Each—Plans negotiate; applies out of network—ODM DMEPOS payment schedule (appendix to
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$1.35since 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 A4338?

It depends on the state. Of the 23 states with a published fee-for-service rate, the median is $11.18. Arizona pays the most ($18.77) and New York the least ($1.35).

Which state pays the highest Medicaid rate for A4338?

Arizona, at $18.77, effective 2026-10-01.

Do managed-care plans pay the same rate for A4338?

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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