Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for A4231. Full schedules include every locality, modifier, and age-band variant.
- Every code on all 51 published schedules
- Full-schedule CSV export and state network lists
- Email alerts when a state changes its rates
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Publishing states
33
Median % of Medicare
--
Rate range
$0.01 - $134.29
A4231 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arkansas | $2.88 | -- | -- | 2026 |
| Colorado | $8.73 | -- | Required | 2026 |
| Connecticut | $8.00 | -- | -- | 2006 |
| District of Columbia | $50.00 | -- | Required | 1997 |
| Florida | $93.48 | -- | -- | 2026 |
| Georgia | $16.00* | -- | -- | 2026 |
| Hawaii | $3.88 | -- | -- | 2025 |
| Iowa | $72.41 | -- | -- | 2024 |
| Illinois | $13.35 | -- | -- | 2026 |
| Indiana | $7.40 | -- | -- | 2026 |
| Kansas | $9.21 | -- | -- | 2005 |
| Kentucky | $73.30 | -- | -- | 2026 |
| Maine | $15.05 | -- | -- | 2026 |
| Michigan | $4.85 | -- | -- | 2026 |
| Missouri | $0.01 | -- | Not required | 2004 |
| Mississippi | $8.59* | -- | -- | 2026 |
| North Dakota | $7.03 | -- | Not required | 2026 |
| New Hampshire | $5.32 | -- | Not required | 2026 |
| New Mexico | $6.53 | -- | -- | 2025 |
| Nevada | $5.06 | -- | -- | 2011 |
| New York | $6.33 | -- | -- | 2026 |
| Ohio | $9.45 | -- | Not required | 2024 |
| Oklahoma | $6.04 | -- | -- | 2020 |
| Pennsylvania | $6.93 | -- | -- | 2008 |
| South Carolina | $15.51 | -- | -- | 2025 |
| Texas | $6.27* | -- | -- | 2019 |
| Utah | $9.98* | -- | Not required | 2026 |
| Virginia | $6.91 | -- | -- | 2010 |
| Vermont | $5.39 | -- | -- | 2026 |
| Washington | $134.29 | -- | -- | 2026 |
| Wisconsin | $6.24 | -- | -- | 2008 |
| West Virginia | $14.00 | -- | -- | 2026 |
| Wyoming | $6.44 | -- | -- | 2021 |
Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Rows marked * are representative published variants or methodology-derived rates. "--" in the prior-auth column means the state publishes no PA flag.
Related dme & supplies codes
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- A2005 - Microlyte matrix, per square centimeter (add-on, list separately in addition to primary procedure)
- A2006 - Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)
- A2007 - Restrata, per square centimeter (add-on, list separately in addition to primary procedure)
- A2008 - Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)
- A2009 - Symphony, per square centimeter (add-on, list separately in addition to primary procedure)
- A2010 - Apis, per square centimeter (add-on, list separately in addition to primary procedure)
All 238 codes from A4206 to A4932 or every dme & supplies code by number.
Frequently asked questions
How much does Medicaid pay for A4231?
33 state Medicaid programs publish a fee-for-service rate for A4231 (infusion set for external insulin pump, needle type), ranging from $0.01 in Missouri to $134.29 in Washington. The full table on this page lists every publishing state's current rate.
Which state pays the most for A4231?
Washington publishes the highest Medicaid rate for A4231 at $134.29. Missouri publishes the lowest at $0.01.
Does A4231 require prior authorization under Medicaid?
2 of the 33 publishing states flag A4231 as requiring prior authorization (always or conditionally) on their fee schedules. States without a flag publish no PA indicator for this code - that means "not published", not "no PA required".