S9001 Medicaid reimbursement rate by state (2026)
Home uterine monitor with or without associated nursing.... Medicaid pays a median of $62.28 for S9001 across 6 states, from $46.84 in Michigan to $2,468.82 in Nebraska.
- States publishing
- 6
- National median
- $62.28units vary by state
- Lowest
- $46.84Michigan
- Highest
- $2,468.82Nebraska
What does Medicaid pay for S9001?
6 state Medicaid programs publish a fee-for-service rate for S9001. The national median is $62.28 (units differ between states). Nebraska pays the most, $2,468.82, and Michigan the least, $46.84, a 52.7x spread.
S9001 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 6 states with every variant, modifier and effective date.
How to read this table
- Order. States are listed from the highest published rate to the lowest. No single unit is shared by 8 or more states for S9001, 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. 1 of the 6 states list more than one rate for S9001, 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. None of the 6 schedules prints a separate unit for S9001, so each amount is a flat payment for one service as the code defines it.
- Per hour. S9001 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 S9001, 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.
Why S9001 rates differ between states
Published rates for S9001 run from $46.84 in Michigan to $2,468.82 in Nebraska, a 52.7x gap in the same unit. Half the states pay more than the median of $62.28 and half pay less. The usual reasons for a spread like this in equipment & supplies rates:
- Many states set equipment and supply fees as a percentage of the Medicare DMEPOS fee schedule, at different percentages and from different years.
- 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.
Timing matters too. 1 state set the current rate for S9001 in 2026 or later, while 2 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.
What managed-care plans pay for S9001
What a plan pays for S9001 is negotiated privately, but the state decides how much room there is to negotiate. Here is how the rules break down across the 6 states.
In 1 state, the published rate binds plans: a floor, a pass-through or a state-set rate. In 4 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 1 state is not classified yet.
- Plans negotiate; the published rate applies out of network (4 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 Nebraska managed care.
Units and billing for S9001
S9001 is a HCPCS Level II temporary national code in the equipment & supplies line, billed mostly by durable medical equipment suppliers, orthotists, prosthetists and pharmacies. S codes were created for private payers and are widely used by Medicaid programs for services Medicare does not cover, such as home nursing and home infusion. Units range from 15 minutes to a day.
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.
Frequently asked questions
What does Medicaid pay for S9001?
It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $62.28. Nebraska pays the most ($2,468.82) and Michigan the least ($46.84).
Which state pays the highest Medicaid rate for S9001?
Nebraska, at $2,468.82, effective 2026-07-01.
Which state pays the lowest Medicaid rate for S9001?
Michigan, at $46.84, effective 2023-01-01.
What unit is S9001 billed in?
None of the 6 schedules prints a separate unit for S9001, so each amount is a flat payment for one service as the code defines it.
Do managed-care plans pay the same rate for S9001?
Not necessarily. In 1 state, the published rate binds plans: a floor, a pass-through or a state-set rate. In 4 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 1 state is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.