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A4434 Medicaid reimbursement rates by state

Ostomy pouch, urinary. 28 state Medicaid programs publish a fee-for-service rate for A4434 at the nurse midwife level. Rates run from $0.01 in Missouri to $6.32 in Kentucky, with a median of $3.95.

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

States publishing
28
Median rate
$3.95units vary by state
Highest
$6.32Kentucky
Medicare (non-facility)
—not on the physician fee schedule

A4434 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
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$6.32since 2022-01-01——Plans negotiate; applies out of network—KY Medicaid Home Health fee schedule (20
ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$5.76since 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)$5.36since 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)$5.36since 2026-01-01——Plans must pay at least this—SoonerCare Durable Medical Equipment Rat
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$5.00since 2025-10-01——Plans negotiate; applies out of network—NC Medicaid fee schedule 'Durable Medica
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$4.82since 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)$4.68since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$4.56since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$4.36since 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)$4.33since 2024-07-01——Not classified—SCDHHS Durable Medical Equipment (DME) F
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$4.29since 2026-07-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$4.10since 2024-10-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$4.02since 2021-01-01——Plans negotiate; applies out of network—HCA Medical equipment and supplies fee s
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$3.99since 2022-06-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$3.92since 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)$3.88since 2024-07-01——State sets the plan rate—Iowa Medicaid fee schedule #08 PHARMACY
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$3.80since 2008-07-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Supplies
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$3.75since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$3.75since 2014-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$3.57since 2024-01-01——Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2024-01-
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$3.20since 2007-05-01——Not classified—CMAP fee schedule: 10/01/2026 MEDS - Med
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$3.01since 2005-02-07——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)$2.98since 2021-07-01Each—Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$2.96since 2011-04-01——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)$2.74since 2012-07-01——Plans must pay at least this—Louisiana Medicaid Durable Medical Equip
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$2.65since 2023-01-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
FloridaAny qualified provider (rate does not vary by provider) · Florida iBudget waiver for people with developmental disabilities (APD)$2.41since 2015-10-19——Paid by the state, outside plans—Developmental Disabilities Individual Bu
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$0.01since 2004-02-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Home Health

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 A4434?

It depends on the state. Of the 28 states with a published fee-for-service rate, the median is $3.95. Kentucky pays the most ($6.32) and Missouri the least ($0.01).

Which state pays the highest Medicaid rate for A4434?

Kentucky, at $6.32, effective 2022-01-01.

Do managed-care plans pay the same rate for A4434?

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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