A4342 Medicaid reimbursement rates by state
Accessories for patient inserted indwelling intraurethral.... 6 state Medicaid programs publish a fee-for-service rate for A4342. Rates run from $524.80 in Ohio to $860.84 in Indiana, with a median of $752.41.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 6
- Median rate
- $752.41units vary by state
- Highest
- $860.84Indiana
- Medicare (non-facility)
- —not on the physician fee schedule
A4342 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 |
|---|---|---|---|---|---|---|
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $860.84since 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) | $819.36since 2023-04-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS Arizona Health Care Cost Containm |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $790.25since 2026-01-01 | Each | — | 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) | $714.56since 2026-03-01 | — | — | Plans negotiate; applies out of network | — | Rates for Durable Medical Equipment, Oxy |
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $652.83since 2026-07-01 | — | — | Not classified | — | Health First Colorado Physician Fee Sche |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $524.80since 2023-04-01 | Each | — | Plans negotiate; applies out of network | — | ODM DMEPOS combined payment schedules (a |
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 A4342?
It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $752.41. Indiana pays the most ($860.84 per unit) and Ohio the least ($524.80 per Each).
Which state pays the highest Medicaid rate for A4342?
Indiana, at $860.84 per unit, effective 2026-01-01.
Do managed-care plans pay the same rate for A4342?
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.