K1005 Medicaid reimbursement rates by state
Disposable collection and storage bag for breast milk. 6 state Medicaid programs publish a fee-for-service rate for K1005. Rates run from $0.21 in Pennsylvania to $0.38 in Colorado, with a median of $0.295.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 6
- Median rate
- $0.295units vary by state
- Highest
- $0.38Colorado
- Medicare (non-facility)
- —not on the physician fee schedule
K1005 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.
| State | Medicaid rate | Unit | Per hour | Managed-care plans | % of Medicare | Source |
|---|---|---|---|---|---|---|
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $0.38since 2023-01-01 | — | — | Not classified | — | Health First Colorado Physician Fee Sche |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $0.33since 2022-01-01 | Each | — | Plans negotiate; applies out of network | — | Appendix to OAC 5160-10-01, final filed |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $0.32since 2020-09-25 | — | — | Plans negotiate; applies out of network | — | HFS DME Fee Schedule (effective 2020-09- |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $0.27since 2023-02-01 | — | — | Plans negotiate; applies out of network | — | NC Medicaid fee schedule 'Durable Medica |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $0.25since 2023-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Medical Suppliers/Orthotists/Prost |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $0.21since 2022-12-25 | per bag | — | Plans negotiate; applies out of network | — | 52 Pa.B. 7567 Medical Assistance Program |
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 K1005?
It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $0.295. Colorado pays the most ($0.38) and Pennsylvania the least ($0.21 per per bag).
Which state pays the highest Medicaid rate for K1005?
Colorado, at $0.38, effective 2023-01-01.
Do managed-care plans pay the same rate for K1005?
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.