A6221 Medicaid Rate by State

Gauze, non-impregnated, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing

21 state Medicaid programs publish a fee-for-service rate for A6221 (gauze, non-impregnated, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing), ranging from $0.01 in Missouri to $25.99 in Connecticut.

Every state, kept current

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This page shows one representative rate per state for A6221. Full schedules include every locality, modifier, and age-band variant.

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Publishing states

21

Median % of Medicare

--

Rate range

$0.01 - $25.99

A6221 rates in every publishing state

StateMedicaid rate% of MedicarePrior authVintage
Arkansas$2.31----2026
Colorado$9.38--Required2026
Connecticut$25.99----2003
District of Columbia$2.57--Not required2023
Delaware$2.46----2026
Hawaii$4.16----2025
Idaho$1.05--Not required2025
Indiana$0.81----2026
Kansas$4.00----2007
Louisiana$1.95----2026
Maine$0.17----2026
Michigan$3.68----2026
Missouri$0.01--Not required2003
New York$2.44----2026
Ohio$0.52----2006
Pennsylvania$3.63----1997
Texas$2.42*----2017
Washington$3.18----2026
Wisconsin$1.10----2008
West Virginia$1.93----2026
Wyoming$1.76----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 171 codes from A6010 to A6610 or every dme & supplies code by number.

Frequently asked questions

How much does Medicaid pay for A6221?

21 state Medicaid programs publish a fee-for-service rate for A6221 (gauze, non-impregnated, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing), ranging from $0.01 in Missouri to $25.99 in Connecticut. The full table on this page lists every publishing state's current rate.

Which state pays the most for A6221?

Connecticut publishes the highest Medicaid rate for A6221 at $25.99. Missouri publishes the lowest at $0.01.

Does A6221 require prior authorization under Medicaid?

1 of the 21 publishing states flag A6221 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".