Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for A4458. 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
$29/mo after the trial. Cancel anytime.
Publishing states
13
Median % of Medicare
--
Rate range
$0.01 - $16.42
A4458 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Georgia | $6.00* | -- | -- | 2026 |
| Hawaii | $1.86 | -- | -- | 2025 |
| Idaho | $8.64 | -- | Not required | 2025 |
| Michigan | $5.18 | -- | -- | 2026 |
| Missouri | $0.01 | -- | Not required | 2004 |
| North Carolina | $3.19 | -- | -- | 2025 |
| New Hampshire | $5.05 | -- | Not required | 2026 |
| New York | $16.42 | -- | -- | 2026 |
| Ohio | $8.00 | -- | Not required | 2004 |
| South Carolina | $4.04 | -- | -- | 2024 |
| Virginia | $1.29 | -- | -- | 2010 |
| Wisconsin | $2.15 | -- | -- | 2008 |
| Wyoming | $9.75 | -- | -- | 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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- 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 A4458?
13 state Medicaid programs publish a fee-for-service rate for A4458 (enema bag with tubing, reusable), ranging from $0.01 in Missouri to $16.42 in New York. The full table on this page lists every publishing state's current rate.
Which state pays the most for A4458?
New York publishes the highest Medicaid rate for A4458 at $16.42. Missouri publishes the lowest at $0.01.
Does A4458 require prior authorization under Medicaid?
No publishing state flags A4458 with a prior-authorization indicator on its fee schedule. Absence of a flag means the state publishes none, not that PA is never required - confirm through the state's provider manual.