Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for A4267. 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
32
Median % of Medicare
--
Rate range
$0.06 - $14.99
A4267 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alaska | $0.42 | -- | -- | 2026 |
| California | $14.99 | -- | -- | 2026 |
| Colorado | $0.34 | -- | -- | 2026 |
| Connecticut | $0.51 | -- | -- | 2026 |
| Hawaii | $0.26 | -- | -- | 2025 |
| Iowa | $0.16 | -- | -- | 2013 |
| Illinois | $0.44 | -- | -- | 2026 |
| Indiana | $0.58 | -- | -- | 2026 |
| Kansas | $0.40 | -- | -- | 2003 |
| Kentucky | $0.25 | -- | -- | 2026 |
| Louisiana | $0.06 | -- | -- | 2026 |
| Massachusetts | $0.19 | -- | -- | 2025 |
| Michigan | $0.06 | -- | -- | 2026 |
| Minnesota | $0.60 | -- | Conditional | 2022 |
| Mississippi | $0.27 | -- | -- | 2026 |
| Montana | $3.65 | -- | Not required | 2026 |
| North Carolina | $0.25 | -- | -- | 2025 |
| North Dakota | $0.46 | -- | Not required | 2026 |
| Nebraska | $3.30 | -- | -- | 2026 |
| New Hampshire | $2.66 | -- | Not required | 2026 |
| New Mexico | $0.49 | -- | -- | 2025 |
| Nevada | $0.38 | -- | -- | -- |
| New York | $0.40 | -- | -- | 2026 |
| Ohio | $0.40 | -- | -- | 2003 |
| Oklahoma | $0.07 | -- | -- | 2020 |
| Pennsylvania | $0.35 | -- | -- | 2007 |
| South Carolina | $0.87 | -- | -- | 2011 |
| Texas | $0.54* | -- | -- | 2012 |
| Virginia | $1.05 | -- | -- | 2009 |
| Washington | $0.39 | -- | -- | 2026 |
| Wisconsin | $0.54 | -- | -- | 2017 |
| Wyoming | $0.20* | -- | -- | 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.
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- A2008 - Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)
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- 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 A4267?
32 state Medicaid programs publish a fee-for-service rate for A4267 (contraceptive supply, condom, male, each), ranging from $0.06 in Michigan to $14.99 in California. The full table on this page lists every publishing state's current rate.
Which state pays the most for A4267?
California publishes the highest Medicaid rate for A4267 at $14.99. Michigan publishes the lowest at $0.06.
Does A4267 require prior authorization under Medicaid?
1 of the 32 publishing states flag A4267 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".