Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for B4103. 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
16
Median % of Medicare
--
Rate range
$0.60 - $10.23
B4103 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arkansas | $5.86* | -- | -- | 2026 |
| Iowa | $5.00 | -- | -- | 2024 |
| Idaho | $2.35 | -- | Not required | 2025 |
| Indiana | $5.93 | -- | Required | 2026 |
| Louisiana | $1.06 | -- | -- | 2026 |
| Maryland | $3.33 | -- | -- | 2026 |
| Michigan | $1.47 | -- | -- | 2026 |
| Missouri | $2.53* | -- | Not required | 2019 |
| Ohio | $0.60 | -- | -- | 2014 |
| Oklahoma | $5.33 | -- | -- | 2020 |
| Pennsylvania | $2.92 | -- | -- | 2005 |
| South Carolina | $4.84 | -- | -- | 2023 |
| Texas | $3.33* | -- | -- | 2023 |
| Virginia | $5.36 | -- | -- | 2010 |
| Vermont | $10.23 | -- | -- | 2026 |
| Wisconsin | $0.93 | -- | -- | 2012 |
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
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- 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 41 codes from B4034 to B4224 or every dme & supplies code by number.
Frequently asked questions
How much does Medicaid pay for B4103?
16 state Medicaid programs publish a fee-for-service rate for B4103 (enteral formula, for pediatrics, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit), ranging from $0.60 in Ohio to $10.23 in Vermont. The full table on this page lists every publishing state's current rate.
Which state pays the most for B4103?
Vermont publishes the highest Medicaid rate for B4103 at $10.23. Ohio publishes the lowest at $0.60.
Does B4103 require prior authorization under Medicaid?
1 of the 16 publishing states flag B4103 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".