Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for B4162. 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
14
Median % of Medicare
--
Rate range
$1.12 - $26.32
B4162 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arkansas | $6.98* | -- | -- | 2026 |
| Georgia | $4.00* | -- | -- | 2026 |
| Hawaii | $1.12 | -- | -- | 2025 |
| Idaho | $2.11 | -- | Not required | 2025 |
| Indiana | $4.72 | -- | Required | 2026 |
| Louisiana | $26.32 | -- | -- | 2026 |
| Maryland | $3.31 | -- | -- | 2026 |
| Maine | $7.02 | -- | -- | 2026 |
| North Carolina | $3.86 | -- | -- | 2025 |
| New York | $5.36 | -- | -- | 2026 |
| Pennsylvania | $1.43 | -- | -- | 2013 |
| Texas | $8.82* | -- | -- | 2012 |
| Utah | $3.36* | -- | Required | 2019 |
| Wisconsin | $1.30 | -- | -- | 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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- 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 41 codes from B4034 to B4224 or every dme & supplies code by number.
Frequently asked questions
How much does Medicaid pay for B4162?
14 state Medicaid programs publish a fee-for-service rate for B4162 (enteral formula, for pediatrics, special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit), ranging from $1.12 in Hawaii to $26.32 in Louisiana. The full table on this page lists every publishing state's current rate.
Which state pays the most for B4162?
Louisiana publishes the highest Medicaid rate for B4162 at $26.32. Hawaii publishes the lowest at $1.12.
Does B4162 require prior authorization under Medicaid?
2 of the 14 publishing states flag B4162 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".