Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for A4563. 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
72.8%
Rate range
$120.07 - $1,961.93
A4563 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arizona | $1,961.93 | 117.3% | -- | 2026 |
| Delaware | $1,640.30 | 98.1% | -- | 2026 |
| Idaho | $1,417.22 | 84.7% | Not required | 2026 |
| Illinois | $120.07 | 7.2% | -- | 2026 |
| Kansas | $1,337.86 | 80% | -- | 2026 |
| Kentucky | $128.34 | 7.7% | -- | 2026 |
| Nebraska | $137.66 | 8.2% | -- | 2026 |
| New Hampshire | $918.39 | 54.9% | Not required | 2026 |
| New Jersey | $1,148.21 | 68.6% | Not required | 2026 |
| New Mexico | $1,656.42 | -- | -- | 2026 |
| Ohio | $1,318.10 | 78.8% | -- | 2026 |
| Utah | $1,218.30* | 72.8% | Not required | 2026 |
| Wyoming | $125.78 | 7.5% | -- | 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
- 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 A4563?
13 state Medicaid programs publish a fee-for-service rate for A4563 (rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each), ranging from $120.07 in Illinois to $1,961.93 in Arizona, with a median of 72.8% of the national Medicare amount. The full table on this page lists every publishing state's current rate.
Which state pays the most for A4563?
Arizona publishes the highest Medicaid rate for A4563 at $1,961.93 (117.3% of the national Medicare amount). Illinois publishes the lowest at $120.07.
Does A4563 require prior authorization under Medicaid?
No publishing state flags A4563 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.