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A5122 Medicaid reimbursement rates by state

Skin barrier; solid, 8 x 8 or equivalent, each. 33 state Medicaid programs publish a fee-for-service rate for A5122 at the nurse midwife level. Rates run from $7.58 in Alabama to $19.66 in Arizona, with a median of $12.29.

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

States publishing
33
Median rate
$12.29units vary by state
Highest
$19.66Arizona
Medicare (non-facility)
—not on the physician fee schedule

A5122 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)$19.66since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$18.30since 2026-01-01——Plans must pay at least this—SoonerCare Durable Medical Equipment Rat
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$17.94since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$17.67since 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)$17.09since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$15.98since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$14.79since 2024-07-01——Not classified—SCDHHS Durable Medical Equipment (DME) F
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$14.64since 2026-07-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$14.64since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$14.20since 2017-01-01——Plans negotiate; applies out of network—Provider Type 33, Durable Medical Equipm
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$14.00since 2026-01-01Each—Plans must pay at least this—DMAS procedure fee file hcpcmedical.csv
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$13.52since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$13.42since 2024-07-01——State sets the plan rate—Iowa Medicaid fee schedule #08 PHARMACY
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$13.24since 2019-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Durable Medic
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$13.10since 2021-01-01——Plans negotiate; applies out of network—HCA Medical equipment and supplies fee s
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$12.66since 2026-03-01——Plans negotiate; applies out of network—Rates for Durable Medical Equipment, Oxy
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$12.29since 2025-10-01each—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)$12.29since 2022-01-01——Plans negotiate; applies out of network—KY Medicaid Home Health fee schedule (20
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$12.26since 2001-04-01Each—Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$12.07since 2022-06-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$11.91since 2024-10-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$11.79since 2022-07-01——Not classified—Health First Colorado Physician Fee Sche
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$11.66since 2024-01-01——Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2024-01-
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$11.19since 2008-07-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Supplies
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$10.92since 2007-05-01——Not classified—CMAP fee schedule: 10/01/2026 MEDS - Med
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$10.89since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$10.59since 2025-05-16——Not classified—Arkansas Medicaid Home Health Fee Schedu
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$10.28since 2016-07-01——Plans negotiate; applies out of network—DME Fee Schedule - Excel.xlsx
FloridaAny qualified provider (rate does not vary by provider) · Florida iBudget waiver for people with developmental disabilities (APD)$9.81since 2015-10-19——Paid by the state, outside plans—Developmental Disabilities Individual Bu
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$9.01since 2023-01-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$8.78since 1997-07-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Dmepo
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$8.10since 1991-01-01——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$7.58since 2026-05-20——Not classified—EPSDT Referral (DME) Fee Schedule (REF-0

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 A5122?

It depends on the state. Of the 33 states with a published fee-for-service rate, the median is $12.29. Arizona pays the most ($19.66) and Alabama the least ($7.58).

Which state pays the highest Medicaid rate for A5122?

Arizona, at $19.66, effective 2026-10-01.

Do managed-care plans pay the same rate for A5122?

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

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