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A4722 Medicaid reimbursement rates by state

Dialysate solution, any concentration of dextrose. 5 state Medicaid programs publish a fee-for-service rate for A4722. Rates run from $0.78 in Colorado to $722.23 in Wisconsin, with a median of $18.04.

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

States publishing
5
Median rate
$18.04units vary by state
Highest
$722.23Wisconsin
Medicare (non-facility)
—not on the physician fee schedule

A4722 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
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Chronic Disease Program (adult cystic fibrosis, hemophilia home care, chronic renal disease; state-funded)$722.23⚠ over 3× mediansince 2006-10-01——Not classified—ForwardHealth max fee schedule: Renal Di
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$33.20since 2008-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule (Wayback capture 20250
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$18.04since 2025-09-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$4.69since 2002-01-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$0.78since 2022-07-01——Not classified—Health First Colorado Physician Fee Sche

Rates marked ⚠ are more than three times the median for the same unit; they are published as shown but often reflect an office (non-facility) fee or a different scope of service. 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 A4722?

It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $18.04. Wisconsin pays the most ($722.23) and Colorado the least ($0.78).

Which state pays the highest Medicaid rate for A4722?

Wisconsin, at $722.23, effective 2006-10-01.

Do managed-care plans pay the same rate for A4722?

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

Track A4722 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
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