S9504 Medicaid reimbursement rates by state
Home infusion therapy, antibiotic, antiviral, or antifungal. 13 state Medicaid programs publish a fee-for-service rate for S9504. Rates run from $27.00 in Virginia to $539.99 in South Dakota, with a median of $90.00.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 13
- Median rate
- $90.00per day
- Highest
- $539.99South Dakota
- Medicare (non-facility)
- —not on the physician fee schedule
S9504 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 |
|---|---|---|---|---|---|---|
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services) | $539.99⚠ over 3× mediansince 2026-07-01 | day | — | Not classified | — | South Dakota Medicaid Physician fee sche |
| MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service) | $179.48since 2025-07-01 | day | — | Not classified | — | Montana Healthcare Programs fee schedule |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $107.01since 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) | $102.73since 2026-04-01 | day | — | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $93.27since 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) | $93.10since 2023-03-01 | day | — | Not classified | — | Vermont Medicaid Fee Schedule - DME Code |
| AlaskaAny qualified provider (rate does not vary by provider) · Alaska Medicaid (fee-for-service, Department of Health) | $90.00since 2026-07-01 | day | — | Not classified | — | Alaska Medicaid Home Infusion Therapy Fe |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $73.22since 2026-03-01 | day | — | Plans negotiate; applies out of network | — | Rates for Durable Medical Equipment, Oxy |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $60.00since 2022-01-01 | day | — | State sets the plan rate | — | KY Medicaid DME fee schedule (2022Medica |
| AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules) | $45.00since 2026-05-27 | day | — | Not classified | — | DME/POP Fee Schedule (REF-0132-Q) |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $44.08since 2023-01-01 | day | — | Plans negotiate; applies out of network | — | MDHHS Medical Suppliers/Orthotists/Prost |
| 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 |
Rates marked ⚠ are more than three times the median for the same unit; they are published as shown but often reflect an office (non-facility) fee or a different scope of service. 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 S9504?
It depends on the state. Of the 13 states with a published fee-for-service rate, the median is $90.00 per day. South Dakota pays the most ($539.99 per day) and Virginia the least ($27.00 per day).
Which state pays the highest Medicaid rate for S9504?
South Dakota, at $539.99 per day, effective 2026-07-01.
Do managed-care plans pay the same rate for S9504?
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.