A4500 Medicaid Rate by State

Surgical stockings below knee length, each

29 state Medicaid programs publish a fee-for-service rate for A4500 (surgical stockings below knee length, each), ranging from $0.01 in Missouri to $85.04 in New Hampshire.

Every state, kept current

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This page shows one representative rate per state for A4500. Full schedules include every locality, modifier, and age-band variant.

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Publishing states

29

Median % of Medicare

--

Rate range

$0.01 - $85.04

A4500 rates in every publishing state

StateMedicaid rate% of MedicarePrior authVintage
Alabama$9.95----2026
Colorado$6.81----2026
District of Columbia$49.50--Not required1996
Delaware$30.00----2026
Georgia$14.19*----2026
Hawaii$7.28----2025
Iowa$7.50----2024
Idaho$7.94--Not required2025
Indiana$16.15----2026
Kansas$23.02----1978
Louisiana$35.39----2026
Maryland$49.65----2026
Maine$8.76----2026
Michigan$5.40----2026
Minnesota$15.36--Conditional2026
Missouri$0.01--Not required2003
North Carolina$14.78----2025
Nebraska$16.10----2026
New Hampshire$85.04--Not required2026
Nevada$4.57----2024
New York$12.53----2026
Ohio$22.00----2006
Pennsylvania$15.75----1985
Texas$14.97*----2017
Utah$17.25*--Not required2010
Virginia$16.68----2010
Vermont$67.52----2026
West Virginia$31.50----2026
Wyoming$11.70----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

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

Frequently asked questions

How much does Medicaid pay for A4500?

29 state Medicaid programs publish a fee-for-service rate for A4500 (surgical stockings below knee length, each), ranging from $0.01 in Missouri to $85.04 in New Hampshire. The full table on this page lists every publishing state's current rate.

Which state pays the most for A4500?

New Hampshire publishes the highest Medicaid rate for A4500 at $85.04. Missouri publishes the lowest at $0.01.

Does A4500 require prior authorization under Medicaid?

1 of the 29 publishing states flag A4500 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".