Q0494 Medicaid reimbursement rate by state (2026)

• Order. States are listed from the highest published rate to the lowest. No single unit is shared by 8 or more states for Q0494, 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 15 states list more than one rate for Q0494, 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. Of the 15 states, 1 publish Q0494 per unit, and 14 schedules print no unit at all (a flat amount per service).
• Per hour. Q0494 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 Q0494, 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.

Published rates for Q0494 run from $65.73 in Kansas to $277.00 in Arizona, a 4.2x gap in the same unit. Half the states pay more than the median of $222.83 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. 12 states set the current rate for Q0494 in 2026 or later, while 3 states 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.

No managed-care plan publishes what it pays for Q0494. What is public is the rule each state's plan contracts set, and that rule decides how much the published rate matters when you contract with a plan.

In 1 state, the published rate binds plans: a floor, a pass-through or a state-set rate. In 10 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 4 states is not classified yet.

• Plans negotiate; the published rate applies out of network (10 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 Arizona managed care.

Q0494 is a HCPCS Level II temporary code in the equipment & supplies line, billed mostly by durable medical equipment suppliers, orthotists, prosthetists and pharmacies. Q codes are temporary codes for drugs, biologicals, supplies and services. The unit depends on the code and is often a dose or an item.

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.