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A4402 Medicaid reimbursement rates by state

Lubricant, per ounce. 23 state Medicaid programs publish a fee-for-service rate for A4402 at the nurse midwife level. Rates run from $0.30 in Michigan to $2.44 in Arizona, with a median of $1.52.

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

States publishing
23
Median rate
$1.52units vary by state
Highest
$2.44Arizona
Medicare (non-facility)
—not on the physician fee schedule

A4402 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)$2.44since 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)$2.27since 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)$2.04since 2026-01-01Per Ounce—Plans must pay at least this—DMAS procedure fee file hcpcmedical.csv
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$1.93since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$1.91since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$1.90since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$1.84since 2024-07-01——Not classified—SCDHHS Durable Medical Equipment (DME) F
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$1.72since 2021-01-01——Plans negotiate; applies out of network—HCA Medical equipment and supplies fee s
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$1.57since 2026-03-01——Plans negotiate; applies out of network—Rates for Durable Medical Equipment, Oxy
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$1.57since 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)$1.52since 2022-07-01——Not classified—Health First Colorado Physician Fee Sche
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$1.52since 2003-05-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Dmepo
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$1.49since 2022-01-01——Plans negotiate; applies out of network—KY Medicaid Home Health fee schedule (20
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$1.39since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
FloridaAny qualified provider (rate does not vary by provider) · Florida iBudget waiver for people with developmental disabilities (APD)$1.35since 2015-10-19——Paid by the state, outside plans—Developmental Disabilities Individual Bu
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$1.32since 2025-10-011 ounce—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)$1.23since 2024-01-01——Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2024-01-
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$1.09since 2016-07-01——Plans negotiate; applies out of network—DME Fee Schedule - Excel.xlsx
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$0.90since 2005-12-12——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)$0.65since 1998-08-01Ounce—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)$0.44since 2023-04-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$0.38since 2008-07-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Supplies
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$0.30since 2023-01-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost

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 A4402?

It depends on the state. Of the 23 states with a published fee-for-service rate, the median is $1.52. Arizona pays the most ($2.44) and Michigan the least ($0.30).

Which state pays the highest Medicaid rate for A4402?

Arizona, at $2.44, effective 2026-10-01.

Do managed-care plans pay the same rate for A4402?

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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