Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for A9604. 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
$29/mo after the trial. Cancel anytime.
Publishing states
15
Median % of Medicare
--
Rate range
$1,652.58 - $23,009.25
A9604 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arkansas | $3,001.81* | -- | -- | 2026 |
| Arizona | $4,099.16 | -- | -- | 2026 |
| California | $16,287.34 | -- | -- | 2026 |
| District of Columbia | $16,282.88 | -- | Not required | 2022 |
| Idaho | $16,037.99 | -- | Not required | 2025 |
| Indiana | $23,009.25 | -- | -- | 2026 |
| Kentucky | $3,159.80 | -- | -- | 2026 |
| Michigan | $1,652.58 | -- | -- | 2026 |
| Missouri | $2,843.82 | -- | Not required | 2026 |
| Mississippi | $3,159.80 | -- | -- | 2026 |
| Montana | $18,562.49 | -- | -- | 2026 |
| New Mexico | $7,665.00 | -- | -- | 2026 |
| Rhode Island | $6,345.64 | -- | -- | 2026 |
| South Carolina | $16,022.36 | -- | -- | 2024 |
| Washington | $16,282.88 | -- | -- | 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 76 codes from A9274 to A9800 or every dme & supplies code by number.
Frequently asked questions
How much does Medicaid pay for A9604?
15 state Medicaid programs publish a fee-for-service rate for A9604 (samarium sm-153 lexidronam, therapeutic, per treatment dose, up to 150 millicuries), ranging from $1,652.58 in Michigan to $23,009.25 in Indiana. The full table on this page lists every publishing state's current rate.
Which state pays the most for A9604?
Indiana publishes the highest Medicaid rate for A9604 at $23,009.25. Michigan publishes the lowest at $1,652.58.
Does A9604 require prior authorization under Medicaid?
No publishing state flags A9604 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.