A4557 Medicaid reimbursement rates by state
Lead wires, (e.g., apnea monitor), per pair. 28 state Medicaid programs publish a fee-for-service rate for A4557 at the physician psychologist level. Rates run from $1.12 in Alabama to $20.52 in North Carolina, with a median of $15.91.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 28
- Median rate
- $15.91units vary by state
- Highest
- $20.52North Carolina
- Medicare (non-facility)
- —not on the physician fee schedule
A4557 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 |
|---|---|---|---|---|---|---|
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $20.52since 2025-10-01 | — | — | Plans negotiate; applies out of network | — | NC Medicaid fee schedule 'Durable Medica |
| New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service) | $19.05since 2022-06-01 | — | — | Plans negotiate; applies out of network | — | eMedNY NYS Medicaid DMEPOS Fee Schedule |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $18.73since 2012-07-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $18.32since 2023-07-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service HCPC |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $17.94since 2005-12-12 | — | — | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $17.94since 2007-05-01 | — | — | Not classified | — | CMAP fee schedule: 10/01/2026 MEDS - Med |
| IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $17.60since 2024-07-01 | — | — | State sets the plan rate | — | Iowa Medicaid fee schedule #08 PHARMACY |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $17.06since 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) | $16.88since 2016-07-01 | — | — | Plans negotiate; applies out of network | — | DME Fee Schedule - Excel.xlsx |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $16.53since 2008-07-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Supplies |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $16.36since 2004-10-01 | Pair | — | Plans negotiate; applies out of network | — | ODM DMEPOS combined payment schedules (a |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $16.18since 2026-01-01 | Pair | — | Plans must pay at least this | — | DMAS procedure fee file hcpcmedical.csv |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $16.05since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP) | $15.97since 2017-04-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Dmepo |
| MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service) | $15.85since 2026-07-01 | — | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, Septembe |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $15.54since 2024-01-01 | — | — | Plans must pay at least this | — | Provider Type 20 Physician, MD., Osteopa |
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $13.40since 2021-07-01 | — | — | Not classified | — | Health First Colorado Physician Fee Sche |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $13.31since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $12.93since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Durable |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $12.86since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $12.23since 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) | $12.04since 2026-01-01 | — | — | Plans must pay at least this | — | SoonerCare Durable Medical Equipment Rat |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $11.88since 2023-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Medical Suppliers/Orthotists/Prost |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $10.53since 2026-03-01 | — | — | Plans negotiate; applies out of network | — | Rates for Durable Medical Equipment, Oxy |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $10.53since 2020-01-01 | — | — | State sets the plan rate | — | KY Medicaid DME fee schedule (2020Medica |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $9.78since 2026-07-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $8.76since 2026-07-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules) | $1.12since 2026-05-20 | — | — | Not classified | — | EPSDT Referral (DME) Fee Schedule (REF-0 |
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 A4557?
It depends on the state. Of the 28 states with a published fee-for-service rate, the median is $15.91. North Carolina pays the most ($20.52) and Alabama the least ($1.12).
Which state pays the highest Medicaid rate for A4557?
North Carolina, at $20.52, effective 2025-10-01.
Do managed-care plans pay the same rate for A4557?
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
A7000Canister, disposable, used with suction pump, each · 35 statesA8001Helmet, protective, hard, prefabricated · 35 statesB9002Enteral nutrition infusion pump, any type · 35 statesE0105Cane, quad or three prong, includes canes of all materials · 35 statesE0130Walker, rigid (pickup), adjustable or fixed height · 35 statesE0135Walker, folding (pickup), adjustable or fixed height · 35 statesE0143Walker, folding, wheeled, adjustable or fixed height · 35 statesE0149Walker, heavy duty, wheeled, rigid or folding, any type · 35 statesE0155Wheel attachment, rigid pick-up walker, per pair · 35 statesE0163Commode chair, mobile or stationary, with fixed arms · 35 statesE0184Dry pressure mattress · 35 statesE0185Gel or gel-like pressure pad for mattress · 35 states
Track A4557 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.