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A6254 Medicaid reimbursement rates by state

Specialty absorptive dressing, wound cover, sterile. 23 state Medicaid programs publish a fee-for-service rate for A6254 at the clinical nurse specialist level. Rates run from $0.01 in Missouri to $1.83 in Arizona, with a median of $1.24.

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

States publishing
23
Median rate
$1.24units vary by state
Highest
$1.83Arizona
Medicare (non-facility)
—not on the physician fee schedule

A6254 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
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$1.83since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$1.70since 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)$1.67since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$1.53since 2026-01-01Each—Plans must pay at least this—DMAS procedure fee file hcpcmedical.csv
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$1.48since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$1.45since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$1.39since 2026-03-01——Plans negotiate; applies out of network—Rates for Durable Medical Equipment, Oxy
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$1.38since 2024-07-01——Not classified—SCDHHS Durable Medical Equipment (DME) F
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$1.29since 2021-01-01——Plans negotiate; applies out of network—HCA Medical equipment and supplies fee s
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$1.26since 2022-07-01——Not classified—Health First Colorado Physician Fee Sche
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$1.24since 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)$1.24since 2022-01-01——Plans negotiate; applies out of network—KY Medicaid Home Health fee schedule (20
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$1.19since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$1.16since 1997-07-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Dmepo
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$1.10since 2024-01-01——Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2024-01-
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$1.08since 2022-06-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$1.07since 1997-01-01——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$1.06since 2023-01-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$0.97since 2026-07-01——Plans negotiate; applies out of network—Durable Medical Equipment and Medical Su
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$0.93since 2012-03-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Supplies
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$0.90since 1997-01-01Each—Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$0.78since 2021-09-01——Plans must pay at least this—Louisiana Medicaid Durable Medical Equip
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$0.01since 2003-10-16——Plans negotiate; applies out of network—MO HealthNet fee schedule: Home Health

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 A6254?

It depends on the state. Of the 23 states with a published fee-for-service rate, the median is $1.24. Arizona pays the most ($1.83) and Missouri the least ($0.01).

Which state pays the highest Medicaid rate for A6254?

Arizona, at $1.83, effective 2026-10-01.

Do managed-care plans pay the same rate for A6254?

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 A6254 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
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