S9562 Medicaid reimbursement rates by state
Home injectable therapy. 5 state Medicaid programs publish a fee-for-service rate for S9562. Rates run from $9.62 in Massachusetts to $1,502.02 in New Mexico, with a median of $68.34.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 5
- Median rate
- $68.34per day
- Highest
- $1,502.02New Mexico
- Medicare (non-facility)
- —not on the physician fee schedule
S9562 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 |
|---|---|---|---|---|---|---|
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $1,502.02⚠ over 3× mediansince 2025-01-01 | day | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service HCPC |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $68.34since 2012-01-01 | day | — | 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) | $68.34since 2023-01-01 | day | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $15.00since 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) | $9.62since 2026-03-01 | day | — | Plans negotiate; applies out of network | — | Rates for Durable Medical Equipment, Oxy |
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 S9562?
It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $68.34 per day. New Mexico pays the most ($1,502.02 per day) and Massachusetts the least ($9.62 per day).
Which state pays the highest Medicaid rate for S9562?
New Mexico, at $1,502.02 per day, effective 2025-01-01.
Do managed-care plans pay the same rate for S9562?
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.