Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for A5054. 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
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Publishing states
43
Median % of Medicare
75.1%
Rate range
$0.01 - $3.18
A5054 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $1.43 | 55.6% | -- | 2026 |
| Arkansas | $1.67 | 65% | -- | 2026 |
| Arizona | $3.06 | 119.1% | -- | 2026 |
| Colorado | $1.82 | 70.8% | -- | 2026 |
| Connecticut | $1.52 | 59.1% | -- | 2007 |
| District of Columbia | $2.05 | 79.8% | Not required | 2026 |
| Delaware | $2.56 | 99.6% | -- | 2026 |
| Florida | $1.37 | 53.3% | -- | 2026 |
| Georgia | $1.43* | 55.6% | -- | 2026 |
| Hawaii | $1.79 | 69.6% | -- | 2025 |
| Iowa | $2.01 | 78.2% | -- | 2024 |
| Idaho | $2.21 | 86% | Not required | 2026 |
| Illinois | $1.75 | 68.1% | -- | 2026 |
| Indiana | $1.34 | 52.1% | -- | 2014 |
| Kansas | $2.05 | 79.8% | -- | 2026 |
| Kentucky | $1.42 | 55.3% | -- | 2026 |
| Maryland | $2.18 | 84.8% | -- | 2026 |
| Maine | $2.56 | 99.6% | -- | 2026 |
| Michigan | $1.26 | 49% | -- | 2026 |
| Minnesota | $2.56 | 99.6% | Conditional | 2026 |
| Missouri | $0.01 | 0.4% | Not required | 2003 |
| Mississippi | $2.05* | 79.8% | -- | 2026 |
| Montana | $2.56 | 99.6% | Not required | 2026 |
| North Carolina | $1.69 | 65.8% | -- | 2025 |
| North Dakota | $3.18 | 123.7% | Not required | 2026 |
| Nebraska | $2.23 | 86.8% | -- | 2026 |
| New Hampshire | $1.72 | 66.9% | Not required | 2026 |
| New Jersey | $1.79 | 69.6% | Not required | 2026 |
| New Mexico | $2.51 | 97.7% | -- | 2025 |
| Nevada | $1.99 | 77.4% | -- | 2017 |
| New York | $1.70 | 66.1% | -- | 2026 |
| Ohio | $1.79 | 69.6% | -- | 2024 |
| Oklahoma | $2.56 | 99.6% | -- | 2026 |
| Pennsylvania | $1.79 | 69.6% | -- | 1996 |
| South Carolina | $2.07 | 80.5% | -- | 2024 |
| Texas | $1.90* | 73.9% | -- | 2012 |
| Utah | $1.83* | 71.2% | Not required | 2026 |
| Virginia | $2.30 | 89.5% | -- | 2026 |
| Vermont | $2.15 | 83.7% | -- | 2026 |
| Washington | $1.93 | 75.1% | -- | 2026 |
| Wisconsin | $1.50 | 58.4% | -- | 2008 |
| West Virginia | $2.05 | 79.8% | -- | 2026 |
| Wyoming | $2.30 | 89.5% | -- | 2026 |
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 39 codes from A5051 to A5514 or every dme & supplies code by number.
Frequently asked questions
How much does Medicaid pay for A5054?
43 state Medicaid programs publish a fee-for-service rate for A5054 (ostomy pouch, closed; for use on barrier with flange (2 piece), each), ranging from $0.01 in Missouri to $3.18 in North Dakota, with a median of 75.1% of the national Medicare amount. The full table on this page lists every publishing state's current rate.
Which state pays the most for A5054?
North Dakota publishes the highest Medicaid rate for A5054 at $3.18 (123.7% of the national Medicare amount). Missouri publishes the lowest at $0.01.
Does A5054 require prior authorization under Medicaid?
1 of the 43 publishing states flag A5054 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".