S9443 Medicaid reimbursement rates by state
Lactation classes, non-physician provider, per session. 18 state Medicaid programs publish a fee-for-service rate for S9443. Rates run from $5.66 in Illinois to $120.00 in Vermont, with a median of $53.08.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 18
- Median rate
- $53.08units vary by state
- Highest
- $120.00Vermont
- Medicare (non-facility)
- —not on the physician fee schedule
S9443 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 |
|---|---|---|---|---|---|---|
| VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA) | $120.00since 2025-01-01 | — | — | Not classified | — | Vermont Medicaid Fee Schedule - HCPCS (i |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $92.35since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Child Health Plan Plus FY 2026-2027 Fee |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $72.00since 2016-01-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file hcpcmedical.csv |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $69.21since 2025-01-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service HCPC |
| IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $60.68since 2015-01-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #30 SCREENING |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $59.08since 2024-10-01 | — | — | Plans must pay at least this | — | Appendix DD to OAC 5160-1-60 (Non-Instit |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $59.03since 2023-10-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Child and Adolescent Health Center |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $56.00since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule (Wayback capture 20260 |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $54.20since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $51.95since 2024-01-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $50.00since 2024-10-01 | — | — | Plans negotiate; applies out of network | — | MO HealthNet fee schedule: Doula |
| KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $44.00since 2024-08-01 | — | — | Paid by the state, outside plans | — | KMAP Fee Schedule MKN Medicaid (FeeSched |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $40.80since 2026-01-01 | — | — | Plans must pay at least this | — | Louisiana Medicaid Professional Services |
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service) | $25.78since 2026-08-27 | — | — | Not classified | — | Arkansas Medicaid Supportive Maternal Ca |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $19.00since 2022-10-01 | — | — | Plans negotiate; applies out of network | — | Copy of Schedule of Maximum Allw Pymt Ph |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $17.74since 2025-09-01 | — | — | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $15.64since 2025-01-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $5.66since 2024-01-01 | — | — | Plans negotiate; applies out of network | — | HFS Lactation Consultant Services Fee Sc |
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 S9443?
It depends on the state. Of the 18 states with a published fee-for-service rate, the median is $53.08. Vermont pays the most ($120.00) and Illinois the least ($5.66).
Which state pays the highest Medicaid rate for S9443?
Vermont, at $120.00, effective 2025-01-01.
Do managed-care plans pay the same rate for S9443?
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.
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