Q4289 Medicaid reimbursement rates by state
Revoshield + amniotic barrier, per square centimeter. 8 state Medicaid programs publish a fee-for-service rate for Q4289. Rates run from $30.96 in Colorado to $1,859.50 in California, with a median of $88.22.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 8
- Median rate
- $88.22units vary by state
- Highest
- $1,859.50California
- Medicare (non-facility)
- $116.19–$183.512026 physician fee schedule
Q4289 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 |
|---|---|---|---|---|---|---|
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $1,859.50⚠ over 3× mediansince 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $1,859.50⚠ over 3× mediansince 2026-01-01 | — | — | Not classified | — | Maryland Medicaid Professional Services |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $1,859.50⚠ over 3× mediansince 2025-01-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service HCPC |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $92.95since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | ODM CPT/HCPCS procedure code changes for |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $83.49since 2026-01-01 | — | — | Not classified | — | SCDHHS Pediatric Subspecialty and Neonat |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $81.15since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Oral Maxillofacial Surgeon Fee Sch |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $50.55since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $30.96since 2026-07-01 | — | — | Not classified | — | Health First Colorado Physician Fee Sche |
Rates marked ⚠ are more than three times the median for the same unit; they are published as shown but often reflect an office (non-facility) fee or a different scope of service. 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 Q4289?
It depends on the state. Of the 8 states with a published fee-for-service rate, the median is $88.22. California pays the most ($1,859.50) and Colorado the least ($30.96).
Which state pays the highest Medicaid rate for Q4289?
California, at $1,859.50, effective 2026-10-01.
Do managed-care plans pay the same rate for Q4289?
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.