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A7020 Medicaid reimbursement rates by state

Interface for cough stimulating device. 23 state Medicaid programs publish a fee-for-service rate for A7020. Rates run from $0.00 in Arkansas to $41.56 in Pennsylvania, with a median of $16.17.

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

States publishing
23
Median rate
$16.17units vary by state
Highest
$41.56Pennsylvania
Medicare (non-facility)
—not on the physician fee schedule

A7020 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
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$41.56since 2011-08-08——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$41.56since 2011-01-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Durable
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$22.51since 2023-04-01——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)$20.62since 2026-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$20.62since 2026-01-01——Plans must pay at least this—SoonerCare Durable Medical Equipment Rat
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$20.22since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$19.89since 2026-07-01——Plans negotiate; applies out of network—Durable Medical Equipment and Medical Su
IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$19.03since 2024-07-01——State sets the plan rate—Iowa Medicaid fee schedule #08 PHARMACY
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$18.31since 2025-01-01——Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2025-01-
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$17.88since 2026-01-01Each—Plans must pay at least this—DMAS procedure fee file hcpcmedical.csv
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$16.85since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$16.17since 2026-03-01——Plans negotiate; applies out of network—Rates for Durable Medical Equipment, Oxy
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$16.07since 2020-01-01——State sets the plan rate—KY Medicaid DME fee schedule (2020Medica
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$16.00since 2024-01-01Each—Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$15.51since 2021-07-01——Plans negotiate; applies out of network—HCA Respiratory care fee schedule (respi
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$15.41since 2024-07-01——Not classified—SCDHHS Durable Medical Equipment (DME) F
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$15.31since 2023-08-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$14.54since 2024-04-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$13.91since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$13.65since 2023-04-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$13.22since 2012-04-01——Not classified—CMAP fee schedule: 10/01/2026 MEDS - Med
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$12.15since 2016-07-01——Plans negotiate; applies out of network—DME Fee Schedule - Excel.xlsx
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$0.00since 2025-06-04——Not classified—Arkansas Medicaid Prosthetics (includes

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 A7020?

It depends on the state. Of the 23 states with a published fee-for-service rate, the median is $16.17. Pennsylvania pays the most ($41.56) and Arkansas the least ($0.00).

Which state pays the highest Medicaid rate for A7020?

Pennsylvania, at $41.56, effective 2011-08-08.

Do managed-care plans pay the same rate for A7020?

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

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