S0104 Medicaid reimbursement rate by state (2026)
Zidovudine, oral, 100 mg. Medicaid pays a median of $1.66 for S0104 across 5 states, from $0.06 in Utah to $2.14 in New Hampshire.
- States publishing
- 5
- National median
- $1.66units vary by state
- Lowest
- $0.06Utah
- Highest
- $2.14New Hampshire
What does Medicaid pay for S0104?
5 state Medicaid programs publish a fee-for-service rate for S0104. The national median is $1.66 (units differ between states). New Hampshire pays the most, $2.14, and Utah the least, $0.06, a 35.7x spread.
S0104 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 5 states with every variant, modifier and effective date.
Frequently asked questions
What does Medicaid pay for S0104?
It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $1.66. New Hampshire pays the most ($2.14) and Utah the least ($0.06).
Which state pays the highest Medicaid rate for S0104?
New Hampshire, at $2.14, effective 2021-01-01.
Do managed-care plans pay the same rate for S0104?
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.