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Q0486 Medicaid reimbursement rates by state

Monitor control cable for use with electric/pneumatic.... 8 state Medicaid programs publish a fee-for-service rate for Q0486 at the clinical nurse specialist level. Rates run from $242.77 in Illinois to $377.69 in Arizona, with a median of $313.73.

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

States publishing
8
Median rate
$313.73units vary by state
Highest
$377.69Arizona
Medicare (non-facility)
—not on the physician fee schedule

Q0486 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)$377.69since 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)$360.28since 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)$353.22since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$351.65since 2026-07-01——Plans negotiate; applies out of network—HCA Physician-related services fee sched
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$275.80since 2026-01-01——Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$270.40since 2026-01-01——Plans negotiate; applies out of network—Durable Medical Equipment Services Fee S
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$269.66since 2016-01-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Dmepo
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$242.77since 2019-07-24——Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2019-07-

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 Q0486?

It depends on the state. Of the 8 states with a published fee-for-service rate, the median is $313.73. Arizona pays the most ($377.69) and Illinois the least ($242.77).

Which state pays the highest Medicaid rate for Q0486?

Arizona, at $377.69, effective 2026-10-01.

Do managed-care plans pay the same rate for Q0486?

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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