Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for A7028. 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
36
Median % of Medicare
92.4%
Rate range
$19.05 - $58.64
A7028 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arizona | $48.54 | 111.4% | -- | 2026 |
| California | $47.41 | 108.8% | -- | 2026 |
| Colorado | $33.78 | 77.5% | Required | 2026 |
| Connecticut | $32.05 | 73.6% | -- | 2018 |
| District of Columbia | $40.30 | 92.5% | Not required | 2026 |
| Georgia | $39.63* | 91% | -- | 2026 |
| Hawaii | $49.54 | 113.7% | -- | 2025 |
| Iowa | $48.22 | 110.7% | -- | 2024 |
| Idaho | $50.67 | 116.3% | Not required | 2026 |
| Illinois | $48.43 | 111.2% | -- | 2026 |
| Kansas | $34.78 | 79.8% | -- | 2026 |
| Kentucky | $33.56 | 77% | -- | 2026 |
| Massachusetts | $33.41* | 76.7% | -- | 2026 |
| Maryland | $34.26 | 78.6% | -- | 2026 |
| Maine | $58.64* | 134.6% | -- | 2026 |
| Michigan | $36.45 | 83.7% | -- | 2026 |
| Minnesota | $43.48 | 99.8% | Conditional | 2026 |
| Missouri | $50.28* | 115.4% | Not required | 2018 |
| Mississippi | $46.91* | 107.7% | -- | 2026 |
| Montana | $58.64 | 134.6% | Not required | 2026 |
| North Dakota | $57.60 | 132.2% | Not required | 2026 |
| New Hampshire | $19.05 | 43.7% | Not required | 2026 |
| New Jersey | $28.21 | 64.7% | Not required | 2026 |
| New Mexico | $47.35 | 108.7% | -- | 2025 |
| Nevada | $43.92* | -- | -- | 2017 |
| New York | $50.04 | 114.8% | -- | 2026 |
| Ohio | $31.55 | 72.4% | -- | 2024 |
| Oklahoma | $58.64 | 134.6% | -- | 2026 |
| Pennsylvania | $39.63 | 91% | -- | 2009 |
| Texas | $39.63* | 91% | -- | 2017 |
| Utah | $29.80* | 68.4% | Not required | 2026 |
| Virginia | $39.85 | 91.5% | -- | 2026 |
| Vermont | $49.03 | 112.5% | -- | 2026 |
| Washington | $40.26* | 92.4% | -- | 2026 |
| Wisconsin | $21.83 | 50.1% | -- | 2008 |
| Wyoming | $37.48* | 86% | -- | 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 59 codes from A7000 to A7527 or every dme & supplies code by number.
Frequently asked questions
How much does Medicaid pay for A7028?
36 state Medicaid programs publish a fee-for-service rate for A7028 (oral cushion for combination oral/nasal mask, replacement only, each), ranging from $19.05 in New Hampshire to $58.64 in Maine, with a median of 92.4% of the national Medicare amount. The full table on this page lists every publishing state's current rate.
Which state pays the most for A7028?
Maine publishes the highest Medicaid rate for A7028 at $58.64 (134.6% of the national Medicare amount). New Hampshire publishes the lowest at $19.05.
Does A7028 require prior authorization under Medicaid?
2 of the 36 publishing states flag A7028 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".