A4928 Medicaid reimbursement rates by state
Surgical mask, per 20. 7 state Medicaid programs publish a fee-for-service rate for A4928. Rates run from $0.45 in Michigan to $24.16 in Texas, with a median of $17.01.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 7
- Median rate
- $17.01units vary by state
- Highest
- $24.16Texas
- Medicare (non-facility)
- —not on the physician fee schedule
A4928 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 |
|---|---|---|---|---|---|---|
| TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP) | $24.16since 2015-01-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Dmepo |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Chronic Disease Program (adult cystic fibrosis, hemophilia home care, chronic renal disease; state-funded) | $22.96since 2006-10-01 | — | — | Not classified | — | ForwardHealth max fee schedule: Renal Di |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $19.96since 2022-07-01 | — | — | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $17.01since 2025-10-01 | 20/box | — | Plans negotiate; applies out of network | — | NC Medicaid fee schedule 'Home Health Se |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $12.00since 2020-01-01 | — | — | State sets the plan rate | — | KY Medicaid DME fee schedule (2020Medica |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $0.53since 2008-01-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $0.45since 2020-03-01 | — | — | Plans negotiate; applies out of network | — | MDHHS COVID-19, March 2020 |
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 A4928?
It depends on the state. Of the 7 states with a published fee-for-service rate, the median is $17.01. Texas pays the most ($24.16) and Michigan the least ($0.45).
Which state pays the highest Medicaid rate for A4928?
Texas, at $24.16, effective 2015-01-01.
Do managed-care plans pay the same rate for A4928?
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.