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Billing code Q4196 · Pharmacy

Q4196 Medicaid reimbursement rate by state (2026)

Puraply am, per square centimeter (add-on. Medicaid pays a median of $103.75 for Q4196 across 25 states, from $25.26 in Kansas to $175.22 in Nebraska.

Data as of Oct 5, 202625 statesEvery rate links to its official source

States publishing
25
National median
$103.75units vary by state
Lowest
$25.26Kansas
Highest
$175.22Nebraska
Answer

What does Medicaid pay for Q4196?

25 state Medicaid programs publish a fee-for-service rate for Q4196. The national median is $103.75 (units differ between states). Nebraska pays the most, $175.22, and Kansas the least, $25.26, a 6.9x spread.

Medicare (non-facility, 2026 physician fee schedule): $109.70–$183.51 depending on the state's Medicare locality.

State ranking

Q4196 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 25 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Nebraska Source · since 2026-07-01$175.22——Plans negotiate; applies out of network—
2Kentucky Source · since 2020-07-01$140.00——Plans negotiate; applies out of network—
3Oregon Source · since 2026-01-01$127.28——Plans negotiate; applies out of network—
12California Source · since 2026-10-01$103.77——Plans negotiate; applies out of network—
13Ohio Source · since 2024-07-01$103.75——Plans negotiate; applies out of network—
14Texas Source · since 2026-09-01$101.84——Plans negotiate; applies out of network—
24Indiana Source · since 2026-01-01$50.55unit—Plans must pay at least this—
25Kansas Source · since 2025-10-01$25.26——Not classified—
See all 25 states for Q4196 — start free

17 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.

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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 Q4196 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
FAQ

Frequently asked questions

What does Medicaid pay for Q4196?

It depends on the state. Of the 25 states with a published fee-for-service rate, the median is $103.75. Nebraska pays the most ($175.22) and Kansas the least ($25.26).

Which state pays the highest Medicaid rate for Q4196?

Nebraska, at $175.22, effective 2026-07-01.

Do managed-care plans pay the same rate for Q4196?

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 workspace shows the rule for each state, cited to the contract or statute.