A6266 Medicaid reimbursement rate by state (2026)
Gauze, impregnated, other than water, normal saline. Medicaid pays a median of $2.18 for A6266 across 46 states, from $0.13 in Kentucky to $3.92 in New Mexico.
- States publishing
- 46
- National median
- $2.18units vary by state
- Lowest
- $0.13Kentucky
- Highest
- $3.92New Mexico
What does Medicaid pay for A6266?
46 state Medicaid programs publish a fee-for-service rate for A6266. The national median is $2.18 (units differ between states). New Mexico pays the most, $3.92, and Kentucky the least, $0.13, a 30.2x spread.
A6266 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 46 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 A6266, 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. 18 of the 46 states list more than one rate for A6266, 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 46 states, 1 publish A6266 per unit, 1 per per linear yard and 1 per linear yard, and 43 schedules print no unit at all (a flat amount per service).
- Per hour. A6266 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 A6266, 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 A6266 rates differ between states
Published rates for A6266 run from $0.13 in Kentucky to $3.92 in New Mexico, a 30.2x gap in the same unit. Half the states pay more than the median of $2.18 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. 24 states set the current rate for A6266 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 A6266
What a plan pays for A6266 is negotiated privately, but the state decides how much room there is to negotiate. Here is how the rules break down across the 46 states.
In 9 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 21 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 16 states is not classified yet.
- Plans negotiate; the published rate applies out of network (21 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 (8 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.
- The state sets the plan rate (1 state). There is little to negotiate on price. Contracting is about network participation, authorization and billing terms.
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 New Mexico managed care.
Units and billing for A6266
A6266 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.
Pricing modifiers decide which amount applies: NU for a new purchase, RR for a monthly rental and UE for used equipment. 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.
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 A6266?
It depends on the state. Of the 46 states with a published fee-for-service rate, the median is $2.18. New Mexico pays the most ($3.92) and Kentucky the least ($0.13).
Which state pays the highest Medicaid rate for A6266?
New Mexico, at $3.92, effective 2025-01-01.
Which state pays the lowest Medicaid rate for A6266?
Kentucky, at $0.13, effective 2022-01-01.
What unit is A6266 billed in?
Of the 46 states, 1 publish A6266 per unit, 1 per per linear yard and 1 per linear yard, and 43 schedules print no unit at all (a flat amount per service).
Do managed-care plans pay the same rate for A6266?
Not necessarily. In 9 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 21 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 16 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.