S9494 Medicaid reimbursement rates by state
Home infusion therapy, antibiotic, antiviral. 10 state Medicaid programs publish a fee-for-service rate for S9494. Rates run from $8.22 in Idaho to $72.79 in Minnesota, with a median of $33.26.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 10
- Median rate
- $33.26per day
- Highest
- $72.79Minnesota
- Medicare (non-facility)
- —not on the physician fee schedule
S9494 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) | $72.79since 2012-01-01 | day | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA) | $50.53since 2023-03-01 | day | — | Not classified | — | Vermont Medicaid Fee Schedule - DME Code |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $50.00since 2022-01-01 | day | — | State sets the plan rate | — | KY Medicaid DME fee schedule (2022Medica |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $44.86since 2026-03-01 | day | — | Plans negotiate; applies out of network | — | Rates for Durable Medical Equipment, Oxy |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $35.38since 2025-10-01 | day | — | Plans negotiate; applies out of network | — | NC Medicaid fee schedule 'Home Infusion |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $31.13since 2020-08-01 | day | — | Plans must pay at least this | — | SoonerCare Durable Medical Equipment Rat |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $30.27since 2024-07-01 | day | — | Not classified | — | SCDHHS Durable Medical Equipment (DME) F |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $27.00since 2004-01-01 | day | — | Plans negotiate; applies out of network | — | DMAS procedure fee file hcpcmedical.csv |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $8.56since 2011-08-01 | day | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $8.22since 2026-04-01 | day | — | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
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 S9494?
It depends on the state. Of the 10 states with a published fee-for-service rate, the median is $33.26 per day. Minnesota pays the most ($72.79 per day) and Idaho the least ($8.22 per day).
Which state pays the highest Medicaid rate for S9494?
Minnesota, at $72.79 per day, effective 2012-01-01.
Do managed-care plans pay the same rate for S9494?
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.