A6261 Medicaid reimbursement rates by state
Wound filler, gel/paste, per fluid ounce. 14 state Medicaid programs publish a fee-for-service rate for A6261. Rates run from $0.01 in Missouri to $100.00 in Ohio, with a median of $4.10.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 14
- Median rate
- $4.10units vary by state
- Highest
- $100.00Ohio
- Medicare (non-facility)
- —not on the physician fee schedule
A6261 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 |
|---|---|---|---|---|---|---|
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $100.00since 1997-01-01 | month | — | Plans negotiate; applies out of network | — | ODM DMEPOS combined payment schedules (a |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $31.12⚠ over 3× mediansince 2024-10-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $30.28⚠ over 3× mediansince 2009-02-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $26.84since 2025-10-01 | fl. Oz. | — | Plans negotiate; applies out of network | — | NC Medicaid fee schedule 'Home Health Se |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $7.64since 2024-07-01 | — | — | Not classified | — | SCDHHS Durable Medical Equipment (DME) F |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $5.50since 2003-08-01 | — | — | Not classified | — | CMAP fee schedule: 10/01/2026 MEDS - Med |
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $4.48since 2022-07-01 | — | — | Not classified | — | Health First Colorado Physician Fee Sche |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $3.71since 2023-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Medical Suppliers/Orthotists/Prost |
| New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service) | $3.40since 2025-10-01 | — | — | Plans negotiate; applies out of network | — | eMedNY NYS Medicaid DMEPOS Fee Schedule |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $3.35since 2010-07-01 | Ounce | — | Plans negotiate; applies out of network | — | DMAS procedure fee file hcpcmedical.csv |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $1.31since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $0.55since 2022-01-01 | — | — | Plans negotiate; applies out of network | — | KY Medicaid Home Health fee schedule (20 |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $0.19since 2008-07-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Supplies |
| 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 marked ⚠ are more than three times the median for the same unit; they are published as shown but often reflect an office (non-facility) fee or a different scope of service. 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 A6261?
It depends on the state. Of the 14 states with a published fee-for-service rate, the median is $4.10. Ohio pays the most ($100.00 per month) and Missouri the least ($0.01).
Which state pays the highest Medicaid rate for A6261?
Ohio, at $100.00 per month, effective 1997-01-01.
Do managed-care plans pay the same rate for A6261?
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.