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A4633 Medicaid reimbursement rates by state

Replacement bulb/lamp for ultraviolet light therapy system. 7 state Medicaid programs publish a fee-for-service rate for A4633 at the nurse midwife level. Rates run from $32.83 in Pennsylvania to $62.82 in Arizona, with a median of $47.60.

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

States publishing
7
Median rate
$47.60units vary by state
Highest
$62.82Arizona
Medicare (non-facility)
—not on the physician fee schedule

A4633 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)$62.82since 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)$58.49since 2026-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$57.34since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$47.60since 2026-03-01——Plans negotiate; applies out of network—Rates for Durable Medical Equipment, Oxy
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$38.74since 2011-01-01——Plans negotiate; applies out of network—DMAS procedure fee file hcpcmedical.csv
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$36.94since 2019-07-01Each—Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$32.83since 2004-01-01——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (

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 A4633?

It depends on the state. Of the 7 states with a published fee-for-service rate, the median is $47.60. Arizona pays the most ($62.82) and Pennsylvania the least ($32.83).

Which state pays the highest Medicaid rate for A4633?

Arizona, at $62.82, effective 2026-10-01.

Do managed-care plans pay the same rate for A4633?

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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