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A4461 Medicaid reimbursement rates by state

Surgical dressing holder, non-reusable, each. 32 state Medicaid programs publish a fee-for-service rate for A4461 at the nurse midwife level. Rates run from $0.01 in Missouri to $5.05 in Arizona, with a median of $3.80.

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

States publishing
32
Median rate
$3.80units vary by state
Highest
$5.05Arizona
Medicare (non-facility)
—not on the physician fee schedule

A4461 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)$5.05since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service$4.98since 2026-06-01——Plans negotiate; applies out of network—Medicaid Fee-For-Service (FFS) Fee Sched
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$4.70since 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)$4.70since 2026-01-01——Plans must pay at least this—SoonerCare Durable Medical Equipment Rat
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$4.70since 2026-01-01——Not classified—MaineCare Section 60, Medical Supplies a
MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service)$4.70since 2026-01-01——Not classified—Montana Healthcare Programs fee schedule
DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP)$4.70since 2026-01-01——Plans negotiate; applies out of network—DMAP 2026 DME Fee Schedule
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$4.61since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$4.61since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$4.34since 2024-07-01——State sets the plan rate—Iowa Medicaid fee schedule #08 PHARMACY
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$4.23since 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)$4.11since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$4.06since 2026-07-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$4.00since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$3.94since 2025-01-01——Not classified—Vermont Medicaid Fee Schedule - DME Code
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$3.83since 2026-03-01——Plans negotiate; applies out of network—Rates for Durable Medical Equipment, Oxy
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$3.76since 2026-07-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$3.76since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$3.76since 2026-04-01——Plans must pay at least this—BMS DME 2026 Rural Fee Schedule Effectiv
NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$3.64since 2017-01-01——Plans negotiate; applies out of network—Provider Type 33, Durable Medical Equipm
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$3.52since 2021-01-01——Plans negotiate; applies out of network—HCA Medical equipment and supplies fee s
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$3.50since 2021-01-01——Not classified—2026 Fee Schedule - Covered Procedures R
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$3.38since 2025-10-01each—Plans negotiate; applies out of network—NC Medicaid fee schedule 'Home Health Se
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$3.36since 2026-07-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$3.29since 2007-01-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Dmepo
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$3.13since 2022-07-01——Not classified—Health First Colorado Physician Fee Sche
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$3.03since 2011-04-08——Not classified—SCDHHS Pediatric Subspecialty and Neonat
Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service)$3.02since 2012-07-01——Plans negotiate; applies out of network—RI Medicaid Interactive Fee For Service
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$2.80since 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)$2.63since 2008-03-15——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$2.11since 2012-07-01——Plans must pay at least this—Louisiana Medicaid Durable Medical Equip
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$0.01since 2007-01-01——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 A4461?

It depends on the state. Of the 32 states with a published fee-for-service rate, the median is $3.80. Arizona pays the most ($5.05) and Missouri the least ($0.01).

Which state pays the highest Medicaid rate for A4461?

Arizona, at $5.05, effective 2026-10-01.

Do managed-care plans pay the same rate for A4461?

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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