Skip to content
Billing code A9515 · Equipment & supplies

A9515 Medicaid reimbursement rate by state (2026)

Choline c-11, diagnostic. Medicaid pays a median of $5,130.00 for A9515 across 7 states, from $4,920.00 in South Carolina to $5,700.00 in Arkansas.

Data as of Oct 5, 20267 statesEvery rate links to its official source

States publishing
7
National median
$5,130.00units vary by state
Lowest
$4,920.00South Carolina
Highest
$5,700.00Arkansas
Answer

What does Medicaid pay for A9515?

7 state Medicaid programs publish a fee-for-service rate for A9515. The national median is $5,130.00 (units differ between states). Arkansas pays the most, $5,700.00, and South Carolina the least, $4,920.00, a 1.2x spread.

State ranking

A9515 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 7 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Arkansas Source · since 2025-06-13$5,700.00——Not classified—
2Montana Source · since 2025-01-01$5,700.00——Not classified—
3Nebraska Source · since 2026-07-01$5,340.00——Plans negotiate; applies out of network—
7South Carolina Source · since 2024-07-01$4,920.00——Plans negotiate; applies out of network—
See all 7 states for A9515 — start free

3 more states, with every modifier and provider-type variant, rate history and the plan rule in each state. 14-day free trial, no credit card.

  • Source for every rate
  • Full rate history
  • CSV and API export

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; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Track A9515 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
Guide

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 A9515, 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. 4 of the 7 states list more than one rate for A9515, 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. None of the 7 schedules prints a separate unit for A9515, so each amount is a flat payment for one service as the code defines it.
  • Per hour. A9515 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 A9515, 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.
Context

Why A9515 rates differ between states

Published rates for A9515 run from $4,920.00 in South Carolina to $5,700.00 in Arkansas, a 1.2x gap in the same unit. Half the states pay more than the median of $5,130.00 and half pay less. The usual reasons for a spread like this in equipment & supplies rates:

  • A single code can carry separate purchase, rental and used-equipment amounts, and states publish different subsets of them.
  • 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.

Timing matters too. 2 states set the current rate for A9515 in 2026 or later, while 1 state 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.

Managed care

What managed-care plans pay for A9515

Most Medicaid members are in managed-care plans, and plans don't publish their provider fee schedules. For A9515, the public signal is the rule each state sets for its plans, recorded on each rate above.

In 1 state, the published rate binds plans: a floor, a pass-through or a state-set rate. In 3 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 3 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (3 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 (1 state). 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.

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 Arkansas managed care.

Billing

Units and billing for A9515

A9515 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.

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. Pricing modifiers decide which amount applies: NU for a new purchase, RR for a monthly rental and UE for used equipment.

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.

FAQ

Frequently asked questions

What does Medicaid pay for A9515?

It depends on the state. Of the 7 states with a published fee-for-service rate, the median is $5,130.00. Arkansas pays the most ($5,700.00) and South Carolina the least ($4,920.00).

Which state pays the highest Medicaid rate for A9515?

Arkansas, at $5,700.00, effective 2025-06-13.

Which state pays the lowest Medicaid rate for A9515?

South Carolina, at $4,920.00, effective 2024-07-01.

What unit is A9515 billed in?

None of the 7 schedules prints a separate unit for A9515, so each amount is a flat payment for one service as the code defines it.

Do managed-care plans pay the same rate for A9515?

Not necessarily. In 1 state, the published rate binds plans: a floor, a pass-through or a state-set rate. In 3 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 3 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.