S9435 Medicaid reimbursement rates by state
Medical foods for inborn errors of metabolism. 6 state Medicaid programs publish a fee-for-service rate for S9435. Rates run from $3.36 in Utah to $525.00 in Minnesota, with a median of $124.38.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 6
- Median rate
- $124.38units vary by state
- Highest
- $525.00Minnesota
- Medicare (non-facility)
- —not on the physician fee schedule
S9435 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 |
|---|---|---|---|---|---|---|
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $525.00since 2001-01-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $243.25since 2021-04-05 | — | — | Plans negotiate; applies out of network | — | HFS DME Fee Schedule (effective 2021-04- |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $240.00since 2025-09-01 | — | — | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services) | $8.76since 2026-07-01 | — | — | Not classified | — | South Dakota Medicaid Physician fee sche |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $7.17since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan) | $3.36since 2021-08-01 | — | — | Plans negotiate; applies out of network | — | Utah Medicaid Coverage and Reimbursement |
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 S9435?
It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $124.38. Minnesota pays the most ($525.00) and Utah the least ($3.36).
Which state pays the highest Medicaid rate for S9435?
Minnesota, at $525.00, effective 2001-01-01.
Do managed-care plans pay the same rate for S9435?
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.