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A7501 Medicaid reimbursement rates by state

Tracheostoma valve, including diaphragm, each. 19 state Medicaid programs publish a fee-for-service rate for A7501 at the clinical nurse specialist level. Rates run from $0.91 in Louisiana to $160.74 in Arizona, with a median of $112.19.

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

States publishing
19
Median rate
$112.19units vary by state
Highest
$160.74Arizona
Medicare (non-facility)
—not on the physician fee schedule

A7501 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)$160.74since 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)$149.66since 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)$146.73since 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)$134.69since 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)$130.96since 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)$127.21since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$122.25since 2025-10-01——Plans negotiate; applies out of network—NC Medicaid fee schedule 'Durable Medica
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$121.80since 2026-03-01——Plans negotiate; applies out of network—Rates for Durable Medical Equipment, Oxy
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$116.57since 2016-01-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Supplies
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$112.19since 2022-07-01——Not classified—Health First Colorado Physician Fee Sche
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$108.21since 2019-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Durable Medic
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$102.78since 2023-04-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$99.91since 2024-01-01——Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2024-01-
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$97.80since 2024-01-01Each—Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$85.99since 2026-07-01——Plans negotiate; applies out of network—Durable Medical Equipment and Medical Su
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$80.14since 2001-01-01——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$72.47since 2023-01-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$54.59since 2022-01-01——Plans negotiate; applies out of network—KY Medicaid Home Health fee schedule (20
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$0.91since 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 A7501?

It depends on the state. Of the 19 states with a published fee-for-service rate, the median is $112.19. Arizona pays the most ($160.74) and Louisiana the least ($0.91).

Which state pays the highest Medicaid rate for A7501?

Arizona, at $160.74, effective 2026-10-01.

Do managed-care plans pay the same rate for A7501?

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 A7501 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
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