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Billing code S9326 · Equipment & supplies

S9326 Medicaid reimbursement rate by state (2026)

Home infusion therapy, continuous. Medicaid pays a median of $47.20 per day for S9326 across 12 states, from $12.00 in Virginia to $125.64 in Montana.

Data as of Oct 5, 202612 statesEvery rate links to its official source

States publishing
12
National median
$47.20per day
Lowest
$12.00Virginia
Highest
$125.64Montana
Answer

What does Medicaid pay for S9326?

12 state Medicaid programs publish a fee-for-service rate for S9326. The national median is $47.20 per day. Montana pays the most, $125.64 per day, and Virginia the least, $12.00 per day, a 10.5x spread.

State ranking

S9326 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 12 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Montana Source · since 2025-07-01$125.64day—Not classified—
2Vermont Source · since 2023-03-01$96.70day—Not classified—
3Minnesota Source · since 2012-01-01$72.79day—Plans negotiate; applies out of network—
6Kentucky Source · since 2022-01-01$50.00day—State sets the plan rate—
7Oregon Source · since 2009-01-01$44.39day—Plans negotiate; applies out of network—
8Michigan Source · since 2023-01-01$37.65day—Plans negotiate; applies out of network—
11South Carolina Source · since 2024-07-01$30.27day—Not classified—
12Virginia Source · since 2004-01-01$12.00day—Plans negotiate; applies out of network—
See all 12 states for S9326 — start free

4 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.

  • Source for every rate
  • Full rate history
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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 S9326 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
Guide

How to read this table

  • Order. States are listed from the highest published rate to the lowest. A like-for-like rank only counts states that use the same unit: 12 of the 12 states publish S9326 per day, enough to rank them against each other.
  • Medicaid rate. The most the state's fee-for-service program pays for one unit, as published. 3 of the 12 states list more than one rate for S9326, 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. All 12 states publish S9326 per day, so the amounts compare directly.
  • Per hour. S9326 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 S9326, 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.
Context

Why S9326 rates differ between states

Published rates for S9326 run from $12.00 in Virginia to $125.64 in Montana, a 10.5x gap in the same unit. Half the states pay more than the median of $47.20 per day and half pay less. The usual reasons for a spread like this in equipment & supplies rates:

  • 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.
  • A single code can carry separate purchase, rental and used-equipment amounts, and states publish different subsets of them.

Timing matters too. 4 states set the current rate for S9326 in 2026 or later, while 4 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.

Managed care

What managed-care plans pay for S9326

No managed-care plan publishes what it pays for S9326. 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 5 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 6 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (5 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.
  • The state sets the plan rate (1 state). There is little to negotiate on price. Contracting is about network participation, authorization and billing terms.

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 Montana managed care.

Billing

Units and billing for S9326

S9326 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.

FAQ

Frequently asked questions

What does Medicaid pay for S9326?

It depends on the state. Of the 12 states with a published fee-for-service rate, the median is $47.20 per day. Montana pays the most ($125.64 per day) and Virginia the least ($12.00 per day).

Which state pays the highest Medicaid rate for S9326?

Montana, at $125.64 per day, effective 2025-07-01.

Which state pays the lowest Medicaid rate for S9326?

Virginia, at $12.00 per day, effective 2004-01-01.

What unit is S9326 billed in?

All 12 states publish S9326 per day, so the amounts compare directly.

Do managed-care plans pay the same rate for S9326?

Not necessarily. In 1 state, the published rate binds plans: a floor, a pass-through or a state-set rate. In 5 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 6 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.