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A7034 Medicaid reimbursement rates by state

Nasal interface (mask or cannula type) used with positive.... 24 state Medicaid programs publish a fee-for-service rate for A7034 at the clinical nurse specialist level. Rates run from $47.50 in New Jersey to $114.42 in North Carolina, with a median of $75.39.

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

States publishing
24
Median rate
$75.39units vary by state
Highest
$114.42North Carolina
Medicare (non-facility)
—not on the physician fee schedule

A7034 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
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$114.42since 2025-10-01——Plans negotiate; applies out of network—NC Medicaid fee schedule 'Durable Medica
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$111.89since 2025-01-01——Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2025-01-
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$108.59since 2021-07-01——Plans negotiate; applies out of network—HCA Respiratory care fee schedule (respi
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$104.27since 2018-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Durable Medic
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$100.99since 2008-07-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Supplies
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$94.11since 2016-07-01——Plans negotiate; applies out of network—DME Fee Schedule - Excel.xlsx
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$94.11since 2008-01-01——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$90.63since 2012-07-01——Plans must pay at least this—Louisiana Medicaid Durable Medical Equip
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$89.85since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$89.85since 2024-07-01——Not classified—SCDHHS Durable Medical Equipment (DME) F
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$77.92since 2023-01-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$75.59since 2024-07-01New Purchase—Not classified—Durable Medical Equipment Fee Schedule (
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$75.19since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$71.02since 2026-01-01Each—Plans must pay at least this—DMAS procedure fee file hcpcmedical.csv
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$68.28since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$68.16since 2025-09-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Dmepo
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$67.07since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$66.71since 2004-10-01Each—Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$66.45since 2026-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$57.68since 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)$56.55since 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)$54.47since 2020-01-01——State sets the plan rate—KY Medicaid DME fee schedule (2020Medica
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$49.35since 2022-06-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$47.50since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS

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 A7034?

It depends on the state. Of the 24 states with a published fee-for-service rate, the median is $75.39. North Carolina pays the most ($114.42) and New Jersey the least ($47.50).

Which state pays the highest Medicaid rate for A7034?

North Carolina, at $114.42, effective 2025-10-01.

Do managed-care plans pay the same rate for A7034?

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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