Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for A4266. 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
26
Median % of Medicare
--
Rate range
$5.40 - $74.90
A4266 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alaska | $28.00 | -- | -- | 2026 |
| Colorado | $35.20 | -- | -- | 2026 |
| Connecticut | $5.40 | -- | -- | 2026 |
| Iowa | $19.04 | -- | -- | 2024 |
| Idaho | $24.07 | -- | Not required | 2025 |
| Kansas | $24.00 | -- | -- | 2003 |
| Kentucky | $22.00 | -- | -- | 2026 |
| Louisiana | $53.27 | -- | -- | 2026 |
| Massachusetts | $9.77 | -- | -- | 2025 |
| Michigan | $18.50 | -- | -- | 2026 |
| Minnesota | $72.90 | -- | Conditional | 2015 |
| Montana | $54.67 | -- | Not required | 2026 |
| North Dakota | $37.17 | -- | Not required | 2026 |
| New Hampshire | $29.76 | -- | Not required | 2026 |
| New Mexico | $36.65 | -- | -- | 2025 |
| Nevada | $25.07 | -- | -- | 2008 |
| New York | $37.45 | -- | -- | 2026 |
| Ohio | $25.46 | -- | -- | 2003 |
| Oklahoma | $16.01 | -- | -- | 2020 |
| Pennsylvania | $22.86 | -- | -- | 2023 |
| South Carolina | $8.78 | -- | -- | 2014 |
| Texas | $25.27* | -- | -- | 2026 |
| Virginia | $41.35 | -- | -- | 2009 |
| Washington | $74.90 | -- | -- | 2026 |
| Wisconsin | $72.90 | -- | -- | 2017 |
| Wyoming | $24.38* | -- | -- | 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 A4266?
26 state Medicaid programs publish a fee-for-service rate for A4266 (diaphragm for contraceptive use), ranging from $5.40 in Connecticut to $74.90 in Washington. The full table on this page lists every publishing state's current rate.
Which state pays the most for A4266?
Washington publishes the highest Medicaid rate for A4266 at $74.90. Connecticut publishes the lowest at $5.40.
Does A4266 require prior authorization under Medicaid?
1 of the 26 publishing states flag A4266 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".