Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for A5513. 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
37
Median % of Medicare
80%
Rate range
$26.73 - $79.22
A5513 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $29.91 | 54.2% | -- | 2026 |
| Arkansas | $36.14 | 65.5% | -- | 2026 |
| Arizona | $65.98 | 119.6% | -- | 2026 |
| California | $28.91 | 52.4% | -- | 2026 |
| Colorado | $39.24 | 71.1% | -- | 2026 |
| Connecticut | $33.92 | 61.5% | -- | 2007 |
| District of Columbia | $44.13 | 80% | Not required | 2026 |
| Florida | $31.02 | 56.2% | -- | 2026 |
| Hawaii | $37.69 | 68.3% | -- | 2025 |
| Iowa | $36.06 | 65.4% | -- | 2013 |
| Idaho | $47.65* | 86.4% | Not required | 2026 |
| Illinois | $46.62 | 84.5% | -- | 2026 |
| Indiana | $54.08* | 98% | -- | 2026 |
| Kentucky | $32.00 | 58% | -- | 2026 |
| Louisiana | $29.94 | 54.3% | -- | 2026 |
| Massachusetts | $48.38 | 87.7% | -- | 2026 |
| Maryland | $46.89 | 85% | -- | 2026 |
| Maine | $55.16 | 100% | -- | 2026 |
| Michigan | $40.82 | 74% | -- | 2026 |
| Minnesota | $55.16 | 100% | Conditional | 2026 |
| Missouri | $37.23* | 67.5% | Required | 2019 |
| Montana | $55.16 | 100% | Not required | 2026 |
| North Carolina | $35.81 | 64.9% | -- | 2025 |
| North Dakota | $61.59 | 111.7% | Not required | 2026 |
| Nebraska | $48.26 | 87.5% | -- | 2026 |
| New Hampshire | $26.73 | 48.5% | Not required | 2026 |
| New Mexico | $79.22 | 143.6% | -- | 2025 |
| Nevada | $44.93 | 81.5% | -- | 2024 |
| New York | $41.02 | 74.4% | -- | 2026 |
| Ohio | $28.04 | 50.8% | -- | 2010 |
| Oklahoma | $55.16 | 100% | -- | 2026 |
| South Carolina | $44.56 | 80.8% | -- | 2024 |
| Vermont | $46.24 | 83.8% | -- | 2026 |
| Washington | $53.23 | 96.5% | -- | 2026 |
| Wisconsin | $34.47 | 62.5% | -- | 2018 |
| West Virginia | $44.13 | 80% | -- | 2026 |
| Wyoming | $49.64* | 90% | -- | 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 A5513?
37 state Medicaid programs publish a fee-for-service rate for A5513 (for diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each), ranging from $26.73 in New Hampshire to $79.22 in New Mexico, with a median of 80% of the national Medicare amount. The full table on this page lists every publishing state's current rate.
Which state pays the most for A5513?
New Mexico publishes the highest Medicaid rate for A5513 at $79.22 (143.6% of the national Medicare amount). New Hampshire publishes the lowest at $26.73.
Does A5513 require prior authorization under Medicaid?
2 of the 37 publishing states flag A5513 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".