A5052 Medicaid reimbursement rate by state (2026)
Ostomy pouch, closed; without barrier attached (1 piece). Medicaid pays a median of $1.69 for A5052 across 48 states, from $1.11 in Michigan to $4.37 in New Hampshire.
- States publishing
- 48
- National median
- $1.69units vary by state
- Lowest
- $1.11Michigan
- Highest
- $4.37New Hampshire
What does Medicaid pay for A5052?
48 state Medicaid programs publish a fee-for-service rate for A5052. The national median is $1.69 (units differ between states). New Hampshire pays the most, $4.37, and Michigan the least, $1.11, a 3.9x spread.
A5052 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 48 states with every variant, modifier and effective date.
Frequently asked questions
What does Medicaid pay for A5052?
It depends on the state. Of the 48 states with a published fee-for-service rate, the median is $1.69. New Hampshire pays the most ($4.37) and Michigan the least ($1.11).
Which state pays the highest Medicaid rate for A5052?
New Hampshire, at $4.37, effective 2021-01-01.
Do managed-care plans pay the same rate for A5052?
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 workspace shows the rule for each state, cited to the contract or statute.