Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for A4580. 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
$2.55 - $39.00
A4580 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| District of Columbia | $10.50 | -- | Not required | 2015 |
| Hawaii | $14.56 | -- | -- | 2025 |
| Indiana | $10.71 | -- | -- | 2026 |
| Maine | $12.75 | -- | -- | 2026 |
| North Carolina | $4.45 | -- | -- | 2025 |
| New Hampshire | $26.58 | -- | Not required | 2026 |
| Ohio | $2.55 | -- | Not required | 1992 |
| Oklahoma | $33.20 | -- | -- | 2020 |
| Pennsylvania | $28.00 | -- | -- | 2005 |
| South Carolina | $17.27 | -- | -- | 2017 |
| Utah | $30.54* | -- | Not required | 2021 |
| Virginia | $39.00 | -- | -- | 1990 |
| Wyoming | $24.38 | -- | -- | 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 A4580?
13 state Medicaid programs publish a fee-for-service rate for A4580 (cast supplies (e.g., plaster)), ranging from $2.55 in Ohio to $39.00 in Virginia. The full table on this page lists every publishing state's current rate.
Which state pays the most for A4580?
Virginia publishes the highest Medicaid rate for A4580 at $39.00. Ohio publishes the lowest at $2.55.
Does A4580 require prior authorization under Medicaid?
No publishing state flags A4580 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.