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A7016 Medicaid reimbursement rates by state

Dome and mouthpiece, used with small volume ultrasonic.... 18 state Medicaid programs publish a fee-for-service rate for A7016 at the clinical nurse specialist level. Rates run from $4.55 in Louisiana to $11.11 in Arizona, with a median of $6.93.

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

States publishing
18
Median rate
$6.93units vary by state
Highest
$11.11Arizona
Medicare (non-facility)
—not on the physician fee schedule

A7016 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)$11.11since 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)$10.34since 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)$10.14since 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)$9.31since 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)$8.87since 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)$8.79since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$8.11since 2026-01-01——Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$7.94since 2026-03-01——Plans negotiate; applies out of network—Rates for Durable Medical Equipment, Oxy
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$7.26since 2026-07-01New Purchase—Not classified—Durable Medical Equipment Fee Schedule (
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$6.60since 2024-07-01——Not classified—SCDHHS Durable Medical Equipment (DME) F
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$6.53since 2020-01-01——State sets the plan rate—KY Medicaid DME fee schedule (2020Medica
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$6.52since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$6.34since 2023-01-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$5.73since 2012-09-26——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$5.54since 2017-04-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Dmepo
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$5.33since 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)$4.71since 2008-07-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Supplies
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$4.55since 2012-07-01——Plans must pay at least this—Louisiana Medicaid Durable Medical Equip

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 A7016?

It depends on the state. Of the 18 states with a published fee-for-service rate, the median is $6.93. Arizona pays the most ($11.11) and Louisiana the least ($4.55).

Which state pays the highest Medicaid rate for A7016?

Arizona, at $11.11, effective 2026-10-01.

Do managed-care plans pay the same rate for A7016?

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 A7016 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
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