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B4189 Medicaid reimbursement rates by state

Parenteral nutrition solution. 24 state Medicaid programs publish a fee-for-service rate for B4189 at the dietitian level. Rates run from $37.98 in Colorado to $325.26 in Arizona, with a median of $195.76.

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

States publishing
24
Median rate
$195.76units vary by state
Highest
$325.26Arizona
Medicare (non-facility)
—not on the physician fee schedule

B4189 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)$325.26since 2023-04-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$263.06since 2026-01-01——Not classified—MaineCare Section 60, Medical Supplies a
MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service)$263.06since 2026-01-01——Not classified—Montana Healthcare Programs fee schedule
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$257.90since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$257.90since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$227.28since 2026-07-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$225.85since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$214.08since 2026-03-01——Plans negotiate; applies out of network—Rates for Durable Medical Equipment, Oxy
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$210.45since 2026-04-01——Plans must pay at least this—BMS DME 2026 Rural Fee Schedule Effectiv
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$201.49since 2024-10-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
TexasDietitian / nutritionist · Texas Medicaid (fee-for-service, TMHP)$199.85since 2014-01-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - In Ho
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$197.71since 2021-01-01——Plans negotiate; applies out of network—HCA Home infusion therapy/parenteral nut
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$193.80since 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)$184.14since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$184.14since 2026-01-01——Plans must pay at least this—SoonerCare Durable Medical Equipment Rat
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$172.31since 2020-05-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$170.63since 2025-10-01ONE/DAY—Plans negotiate; applies out of network—NC Medicaid fee schedule 'Home Infusion
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$162.42since 2019-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Durable Medic
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$148.89since 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)$139.25since 2023-01-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$85.12since 2024-04-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$67.00since 2005-12-12——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$55.02since 2024-07-01——State sets the plan rate—Iowa Medicaid fee schedule #08 PHARMACY
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$37.98since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee

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 B4189?

It depends on the state. Of the 24 states with a published fee-for-service rate, the median is $195.76. Arizona pays the most ($325.26) and Colorado the least ($37.98).

Which state pays the highest Medicaid rate for B4189?

Arizona, at $325.26, effective 2023-04-01.

Do managed-care plans pay the same rate for B4189?

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.

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