A4580 Medicaid reimbursement rates by state
Cast supplies (e.g., plaster). 6 state Medicaid programs publish a fee-for-service rate for A4580 at the physician psychologist level. Rates run from $2.55 in Ohio to $39.00 in Pennsylvania, with a median of $13.99.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 6
- Median rate
- $13.99units vary by state
- Highest
- $39.00Pennsylvania
- Medicare (non-facility)
- —not on the physician fee schedule
A4580 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 |
|---|---|---|---|---|---|---|
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $39.00since 2005-12-12 | — | — | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $39.00since 1990-01-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file hcpcmedical.csv |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $17.27since 2011-04-08 | — | — | Not classified | — | SCDHHS Pediatric Subspecialty and Neonat |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $10.71since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| North CarolinaPhysician or licensed psychologist (incl. BCBA-D) · North Carolina Medicaid Direct (fee-for-service) | $4.45since 2025-10-01 | — | — | Plans must pay at least this | — | NC Medicaid fee schedule 'Physician Serv |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $2.55since 1992-11-01 | Roll | — | 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 A4580?
It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $13.99. Pennsylvania pays the most ($39.00) and Ohio the least ($2.55 per Roll).
Which state pays the highest Medicaid rate for A4580?
Pennsylvania, at $39.00, effective 2005-12-12.
Do managed-care plans pay the same rate for A4580?
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.