A4642 Medicaid reimbursement rates by state
Indium in-111 satumomab pendetide, diagnostic. 9 state Medicaid programs publish a fee-for-service rate for A4642 at the physician psychologist level. Rates run from $24.60 in Kansas to $1,702.37 in Arizona, with a median of $710.55.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 9
- Median rate
- $710.55units vary by state
- Highest
- $1,702.37Arizona
- Medicare (non-facility)
- —not on the physician fee schedule
A4642 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 |
|---|---|---|---|---|---|---|
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $1,702.37since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Durable |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $1,695.16since 2022-07-01 | — | — | Plans negotiate; applies out of network | — | HCA Physician-related services fee sched |
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services) | $1,635.83since 2026-07-01 | — | — | Not classified | — | South Dakota Medicaid DME fee schedule ( |
| ArkansasPhysician or licensed psychologist (incl. BCBA-D) · Arkansas Medicaid (fee-for-service) | $1,340.00since 2025-06-13 | — | — | Not classified | — | Arkansas Medicaid Physician / CRNA / Fam |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $710.55since 2013-07-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $483.84since 2024-01-01 | — | — | Plans must pay at least this | — | Provider Type 20 Physician, MD., Osteopa |
| WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health) | $97.50since 2021-01-01 | — | — | Not classified | — | Wyoming Medicaid Downloadable Fee Schedu |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $90.00since 2017-11-10 | percent of billed charges | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $24.60since 1995-01-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
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 A4642?
It depends on the state. Of the 9 states with a published fee-for-service rate, the median is $710.55. Arizona pays the most ($1,702.37) and Kansas the least ($24.60).
Which state pays the highest Medicaid rate for A4642?
Arizona, at $1,702.37, effective 2026-10-01.
Do managed-care plans pay the same rate for A4642?
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.