Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for B4159. 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
19
Median % of Medicare
--
Rate range
$0.52 - $2.73
B4159 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arkansas | $2.25* | -- | -- | 2026 |
| Colorado | $1.37 | -- | Required | 2026 |
| Georgia | $1.03* | -- | -- | 2026 |
| Hawaii | $0.56 | -- | -- | 2025 |
| Idaho | $0.57 | -- | Not required | 2025 |
| Indiana | $2.12 | -- | Required | 2026 |
| Louisiana | $0.52 | -- | -- | 2026 |
| Maryland | $0.69 | -- | -- | 2026 |
| Maine | $2.73 | -- | -- | 2026 |
| Michigan | $0.75 | -- | -- | 2026 |
| North Carolina | $0.64 | -- | -- | 2025 |
| North Dakota | $1.69 | -- | Required | 2026 |
| Nebraska | $0.86 | -- | -- | 2026 |
| Nevada | $1.62 | -- | -- | 2011 |
| New York | $0.85 | -- | -- | 2026 |
| Pennsylvania | $1.43 | -- | -- | 2006 |
| South Carolina | $0.62 | -- | -- | 2024 |
| Texas | $1.27* | -- | -- | 2016 |
| Wisconsin | $0.65 | -- | -- | 2005 |
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 B4159?
19 state Medicaid programs publish a fee-for-service rate for B4159 (enteral formula, for pediatrics, nutritionally complete soy based with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit), ranging from $0.52 in Louisiana to $2.73 in Maine. The full table on this page lists every publishing state's current rate.
Which state pays the most for B4159?
Maine publishes the highest Medicaid rate for B4159 at $2.73. Louisiana publishes the lowest at $0.52.
Does B4159 require prior authorization under Medicaid?
3 of the 19 publishing states flag B4159 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".