Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for A9576. 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
20
Median % of Medicare
--
Rate range
$1.03 - $2.79
A9576 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $2.46 | -- | -- | 2026 |
| Arkansas | $2.46 | -- | -- | 2026 |
| Arizona | $1.37 | -- | -- | 2026 |
| California | $1.42 | -- | -- | 2026 |
| Colorado | $2.79 | -- | -- | 2026 |
| District of Columbia | $1.42 | -- | Not required | 2026 |
| Idaho | $1.22 | -- | Not required | 2026 |
| Maine | $1.37 | -- | -- | 2026 |
| Minnesota | $1.36 | -- | -- | 2026 |
| Mississippi | $1.39 | -- | -- | 2026 |
| Montana | $1.42 | -- | -- | 2026 |
| Nebraska | $1.36 | -- | -- | 2026 |
| New Jersey | $1.03 | -- | Not required | 2026 |
| New Mexico | $1.46 | -- | -- | 2025 |
| South Carolina | $1.37 | -- | -- | 2026 |
| Virginia | $1.36 | -- | -- | 2026 |
| Vermont | $1.35 | -- | -- | 2026 |
| Washington | $1.37 | -- | -- | 2026 |
| Wisconsin | $1.41 | -- | -- | 2020 |
| Wyoming | $1.43 | -- | -- | 2022 |
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 76 codes from A9274 to A9800 or every dme & supplies code by number.
Frequently asked questions
How much does Medicaid pay for A9576?
20 state Medicaid programs publish a fee-for-service rate for A9576 (injection, gadoteridol, (prohance multipack), per ml), ranging from $1.03 in New Jersey to $2.79 in Colorado. The full table on this page lists every publishing state's current rate.
Which state pays the most for A9576?
Colorado publishes the highest Medicaid rate for A9576 at $2.79. New Jersey publishes the lowest at $1.03.
Does A9576 require prior authorization under Medicaid?
No publishing state flags A9576 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.