Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for A4412. 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
41
Median % of Medicare
79.8%
Rate range
$0.01 - $15.95
A4412 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arizona | $4.61 | 119.1% | -- | 2026 |
| Colorado | $2.74 | 70.8% | -- | 2026 |
| Connecticut | $2.30 | 59.4% | -- | 2007 |
| District of Columbia | $3.09 | 79.8% | Not required | 2026 |
| Florida | $3.22 | 83.2% | -- | 2026 |
| Georgia | $2.16* | 55.8% | -- | 2026 |
| Hawaii | $1.62 | 41.9% | -- | 2025 |
| Iowa | $3.06 | 79.1% | -- | 2024 |
| Idaho | $3.33 | 86% | Not required | 2026 |
| Illinois | $5.37 | 138.8% | -- | 2026 |
| Indiana | $2.70 | 69.8% | -- | 2014 |
| Kansas | $3.09 | 79.8% | -- | 2026 |
| Kentucky | $2.70 | 69.8% | -- | 2026 |
| Massachusetts | $3.14 | 81.1% | -- | 2026 |
| Maryland | $3.28 | 84.8% | -- | 2026 |
| Maine | $3.86 | 99.7% | -- | 2026 |
| Michigan | $2.48 | 64.1% | -- | 2026 |
| Minnesota | $3.86 | 99.7% | Conditional | 2026 |
| Missouri | $0.01 | 0.3% | Not required | 2006 |
| Mississippi | $3.09* | 79.8% | -- | 2026 |
| Montana | $3.86 | 99.7% | Not required | 2026 |
| North Carolina | $2.78 | 71.8% | -- | 2025 |
| North Dakota | $3.87 | 100% | Not required | 2026 |
| Nebraska | $3.37 | 87.1% | -- | 2026 |
| New Hampshire | $15.95 | 412.1% | Not required | 2026 |
| New Jersey | $2.70 | 69.8% | Not required | 2026 |
| New Mexico | $3.78 | 97.7% | -- | 2025 |
| Nevada | $3.14 | 81.1% | -- | 2024 |
| New York | $2.87 | 74.2% | -- | 2026 |
| Ohio | $2.13 | 55% | -- | 2021 |
| Oklahoma | $3.86 | 99.7% | -- | 2026 |
| Pennsylvania | $2.16 | 55.8% | -- | 2007 |
| South Carolina | $3.11 | 80.4% | -- | 2024 |
| Texas | $2.84* | 73.4% | -- | 2011 |
| Utah | $2.76* | 71.3% | Not required | 2026 |
| Virginia | $3.47 | 89.7% | -- | 2026 |
| Vermont | $3.23 | 83.5% | -- | 2026 |
| Washington | $2.90 | 74.9% | -- | 2026 |
| Wisconsin | $2.34 | 60.5% | -- | 2008 |
| West Virginia | $3.09 | 79.8% | -- | 2026 |
| Wyoming | $3.47 | 89.7% | -- | 2026 |
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
- A2001 - Innovamatrix ac, per square centimeter (add-on, list separately in addition to primary procedure)
- A2002 - Mirragen advanced wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)
- 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 A4412?
41 state Medicaid programs publish a fee-for-service rate for A4412 (ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each), ranging from $0.01 in Missouri to $15.95 in New Hampshire, with a median of 79.8% of the national Medicare amount. The full table on this page lists every publishing state's current rate.
Which state pays the most for A4412?
New Hampshire publishes the highest Medicaid rate for A4412 at $15.95 (412.1% of the national Medicare amount). Missouri publishes the lowest at $0.01.
Does A4412 require prior authorization under Medicaid?
1 of the 41 publishing states flag A4412 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".