Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for B9004. 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
39
Median % of Medicare
--
Rate range
$9.96 - $5,004.33
B9004 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $302.23* | -- | -- | 2026 |
| Arizona | $5,004.33 | -- | -- | 2026 |
| Colorado | $2,656.56 | -- | Required | 2026 |
| Connecticut | $2,168.54 | -- | -- | 2007 |
| District of Columbia | $2,987.22 | -- | Required | 2026 |
| Delaware | $3,734.03 | -- | -- | 2026 |
| Florida | $88.47 | -- | -- | 2026 |
| Georgia | $2,040.98* | -- | -- | 2026 |
| Hawaii | $2,262.63 | -- | -- | 2025 |
| Iowa | $335.79* | -- | -- | 2024 |
| Idaho | $3,226.20* | -- | Not required | 2026 |
| Indiana | $579.51* | -- | -- | 2026 |
| Kansas | $250.00* | -- | -- | 2007 |
| Kentucky | $2,238.01 | -- | -- | 2026 |
| Louisiana | $2,130.73 | -- | -- | 2026 |
| Massachusetts | $3,038.76* | -- | -- | 2026 |
| Maryland | $2,411.31 | -- | Required | 2026 |
| Maine | $295.55* | -- | -- | 2026 |
| Michigan | $10.44* | -- | -- | 2026 |
| Minnesota | $3,734.03 | -- | Conditional | 2026 |
| Missouri | $365.00* | -- | Required | 2019 |
| Mississippi | $9.96* | -- | -- | 2026 |
| Montana | $3,734.03 | -- | Varies | 2026 |
| North Dakota | $313.71 | -- | Required | 2026 |
| Nebraska | $16.91* | -- | -- | 2026 |
| New Jersey | $2,613.82 | -- | Required | 2026 |
| New Mexico | $3,693.47 | -- | -- | 2025 |
| Nevada | $2,246.79 | -- | -- | 2021 |
| New York | $2,775.84 | -- | -- | 2026 |
| Ohio | $2,170.86 | -- | -- | 2010 |
| Oklahoma | $2,613.82 | -- | -- | 2026 |
| South Carolina | $334.59* | -- | -- | 2024 |
| Texas | $283.68* | -- | -- | 2018 |
| Virginia | $3,734.03 | -- | -- | 2026 |
| Vermont | $3,129.99 | -- | -- | 2026 |
| Washington | $2,806.39* | -- | -- | 2026 |
| Wisconsin | $2,283.96 | -- | -- | 2008 |
| West Virginia | $472.88 | -- | -- | 2026 |
| Wyoming | $2,358.09 | -- | Required | 2009 |
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 3 codes from B9002 to B9006 or every dme & supplies code by number.
Frequently asked questions
How much does Medicaid pay for B9004?
39 state Medicaid programs publish a fee-for-service rate for B9004 (parenteral nutrition infusion pump, portable), ranging from $9.96 in Mississippi to $5,004.33 in Arizona. The full table on this page lists every publishing state's current rate.
Which state pays the most for B9004?
Arizona publishes the highest Medicaid rate for B9004 at $5,004.33. Mississippi publishes the lowest at $9.96.
Does B9004 require prior authorization under Medicaid?
8 of the 39 publishing states flag B9004 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".