A4421 Medicaid Rate by State

Ostomy supply; miscellaneous

11 state Medicaid programs publish a fee-for-service rate for A4421 (ostomy supply; miscellaneous), ranging from $0.01 in Missouri to $500.00 in District of Columbia.

Every state, kept current

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This page shows one representative rate per state for A4421. Full schedules include every locality, modifier, and age-band variant.

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Publishing states

11

Median % of Medicare

--

Rate range

$0.01 - $500.00

A4421 rates in every publishing state

StateMedicaid rate% of MedicarePrior authVintage
Alabama$2.50*----2026
Colorado$27.86----2026
District of Columbia$500.00--Required1988
Delaware$200.00----2026
Hawaii$4.68----2025
Idaho$2.71--Not required2025
Indiana$0.21----2026
Maryland$249.90--Required2026
Missouri$0.01--Not required2003
Pennsylvania$1.20----2005
Texas$23.00*----2015

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

All 238 codes from A4206 to A4932 or every dme & supplies code by number.

Frequently asked questions

How much does Medicaid pay for A4421?

11 state Medicaid programs publish a fee-for-service rate for A4421 (ostomy supply; miscellaneous), ranging from $0.01 in Missouri to $500.00 in District of Columbia. The full table on this page lists every publishing state's current rate.

Which state pays the most for A4421?

District of Columbia publishes the highest Medicaid rate for A4421 at $500.00. Missouri publishes the lowest at $0.01.

Does A4421 require prior authorization under Medicaid?

2 of the 11 publishing states flag A4421 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".