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S9537 Medicaid reimbursement rates by state

Home therapy; hematopoietic hormone injection therapy (e.g.. 7 state Medicaid programs publish a fee-for-service rate for S9537. Rates run from $1.86 in South Carolina to $68.34 in Minnesota, with a median of $15.00.

Data as of 2026-10-05. Every rate links to the official document it came from.

States publishing
7
Median rate
$15.00per day
Highest
$68.34Minnesota
Medicare (non-facility)
—not on the physician fee schedule

S9537 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.

StateMedicaid rateUnitPer hourManaged-care plans% of MedicareSource
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$68.34⚠ over 3× mediansince 2012-01-01day—Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$68.34⚠ over 3× mediansince 2023-01-01day—Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$27.00since 2012-07-01day—Plans negotiate; applies out of network—DMAS procedure fee file hcpcmedical.csv
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$15.00since 2022-01-01day—State sets the plan rate—KY Medicaid DME fee schedule (2022Medica
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$13.02since 2023-01-01day—Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$9.62since 2026-03-01day—Plans negotiate; applies out of network—Rates for Durable Medical Equipment, Oxy
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$1.86since 2024-07-01day—Not classified—SCDHHS Durable Medical Equipment (DME) F

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 S9537?

It depends on the state. Of the 7 states with a published fee-for-service rate, the median is $15.00 per day. Minnesota pays the most ($68.34 per day) and South Carolina the least ($1.86 per day).

Which state pays the highest Medicaid rate for S9537?

Minnesota, at $68.34 per day, effective 2012-01-01.

Do managed-care plans pay the same rate for S9537?

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.

Related Other codes

Track S9537 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
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