B4102 Medicaid Rate by State

Enteral formula, for adults, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit

10 state Medicaid programs publish a fee-for-service rate for B4102 (enteral formula, for adults, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit), ranging from $0.42 in Idaho to $5.93 in Indiana.

Every state, kept current

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This page shows one representative rate per state for B4102. Full schedules include every locality, modifier, and age-band variant.

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Publishing states

10

Median % of Medicare

--

Rate range

$0.42 - $5.93

B4102 rates in every publishing state

StateMedicaid rate% of MedicarePrior authVintage
Colorado$0.76--Required2026
Idaho$0.42--Required2025
Indiana$5.93--Required2026
Louisiana$1.06----2026
Maryland$3.56----2026
Michigan$1.47----2026
Ohio$0.60----2014
South Carolina$4.84----2023
Virginia$5.36----2010
Wisconsin$1.86----2006

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 41 codes from B4034 to B4224 or every dme & supplies code by number.

Frequently asked questions

How much does Medicaid pay for B4102?

10 state Medicaid programs publish a fee-for-service rate for B4102 (enteral formula, for adults, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit), ranging from $0.42 in Idaho to $5.93 in Indiana. The full table on this page lists every publishing state's current rate.

Which state pays the most for B4102?

Indiana publishes the highest Medicaid rate for B4102 at $5.93. Idaho publishes the lowest at $0.42.

Does B4102 require prior authorization under Medicaid?

3 of the 10 publishing states flag B4102 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".