A6215 Medicaid reimbursement rate by state (2026)
Foam dressing, wound filler, sterile, per gram. Medicaid pays a median of $2.24 for A6215 across 21 states, from $0.05 in Kentucky to $14.67 in Maryland.
- States publishing
- 21
- National median
- $2.24units vary by state
- Lowest
- $0.05Kentucky
- Highest
- $14.67Maryland
What does Medicaid pay for A6215?
21 state Medicaid programs publish a fee-for-service rate for A6215. The national median is $2.24 (units differ between states). Maryland pays the most, $14.67, and Kentucky the least, $0.05, a 293.4x spread.
A6215 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 21 states with every variant, modifier and effective date.
How to read this table
- Order. States are listed from the highest published rate to the lowest. No single unit is shared by 8 or more states for A6215, so the order is by published amount and is not a like-for-like rank.
- Medicaid rate. The most the state's fee-for-service program pays for one unit, as published. 8 of the 21 states list more than one rate for A6215, by modifier, provider type or setting; the table shows the one that matches the provider level and setting used across states, without add-ons.
- Unit. Of the 21 states, 1 publish A6215 per per gram, 1 per gram and 1 per unit, and 18 schedules print no unit at all (a flat amount per service).
- Per hour. A6215 is not billed in time units in these states, so no hourly figure is shown.
- Managed-care plans. The rule the state sets for its plans on this rate. What each rule means is explained below.
- % of Medicare. No Medicare physician fee schedule amount is on file for A6215, so there is no percentage.
- Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.
Why A6215 rates differ between states
Published rates for A6215 run from $0.05 in Kentucky to $14.67 in Maryland, a 293.4x gap in the same unit. Half the states pay more than the median of $2.24 and half pay less. The usual reasons for a spread like this in equipment & supplies rates:
- Some items are priced individually from the manufacturer's price or the supplier's invoice, so fewer states publish a fixed fee.
- Many states set equipment and supply fees as a percentage of the Medicare DMEPOS fee schedule, at different percentages and from different years.
- A single code can carry separate purchase, rental and used-equipment amounts, and states publish different subsets of them.
Timing matters too. 3 states set the current rate for A6215 in 2026 or later, while 14 states still pay a rate that took effect in 2022 or earlier. A state that has not updated its rate in years will drift down the ranking as others raise theirs.
What managed-care plans pay for A6215
Most Medicaid members are in managed-care plans, and plans don't publish their provider fee schedules. For A6215, the public signal is the rule each state sets for its plans, recorded on each rate above.
In 3 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 11 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 7 states is not classified yet.
- Plans negotiate; the published rate applies out of network (11 states). In-network rates can be above or below the published rate. The published rate is the benchmark both sides know, and the fallback if no contract is signed.
- Plans must pay at least the published rate (3 states). The published rate is your floor. Negotiate up from it, and if a plan pays less, the contract provision is the basis for a payment dispute.
Plan-negotiated rates are never estimated here. To see the rule and its citation for a particular state, open that state's managed-care page, for example Maryland managed care.
Units and billing for A6215
A6215 is a HCPCS Level II transportation and supply code in the equipment & supplies line, billed mostly by durable medical equipment suppliers, orthotists, prosthetists and pharmacies. A codes cover ambulance and transportation services and medical and surgical supplies. Transport codes are paid per trip or per mile; supply codes per item or per box as the code states.
Units follow the code: per item, per pair, per box or per month of rental, so a per-unit comparison only holds when the states use the same unit. Pricing modifiers decide which amount applies: NU for a new purchase, RR for a monthly rental and UE for used equipment.
Before billing, confirm the rate, unit and any modifier with the state's current schedule or the plan: the amounts here are as published, not a guarantee of payment.
Frequently asked questions
What does Medicaid pay for A6215?
It depends on the state. Of the 21 states with a published fee-for-service rate, the median is $2.24. Maryland pays the most ($14.67) and Kentucky the least ($0.05).
Which state pays the highest Medicaid rate for A6215?
Maryland, at $14.67, effective 2020-01-01.
Which state pays the lowest Medicaid rate for A6215?
Kentucky, at $0.05, effective 2022-01-01.
What unit is A6215 billed in?
Of the 21 states, 1 publish A6215 per per gram, 1 per gram and 1 per unit, and 18 schedules print no unit at all (a flat amount per service).
Do managed-care plans pay the same rate for A6215?
Not necessarily. In 3 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 11 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 7 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.