Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for K0455. 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
21
Median % of Medicare
--
Rate range
$11.45 - $3,429.80
K0455 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arizona | $11.45* | -- | -- | 2026 |
| California | $211.90 | -- | -- | 2026 |
| Colorado | $308.26* | -- | Not required | 2026 |
| District of Columbia | $301.97* | -- | Not required | 2026 |
| Hawaii | $339.20 | -- | -- | 2025 |
| Iowa | $253.04* | -- | -- | 2024 |
| Idaho | $3,261.25* | -- | Not required | 2026 |
| Kentucky | $377.46 | -- | -- | 2026 |
| Louisiana | $1,946.34 | -- | -- | 2026 |
| Maine | $320.84* | -- | -- | 2026 |
| Montana | $3,429.80 | -- | Varies | 2026 |
| North Dakota | $339.85 | -- | Required | 2026 |
| New Hampshire | $159.44 | -- | Not required | 2026 |
| New Mexico | $327.12 | -- | -- | 2025 |
| Nevada | $278.30* | -- | -- | 2017 |
| Ohio | $2,960.48 | -- | -- | 2026 |
| Oklahoma | $377.46 | -- | -- | 2026 |
| Pennsylvania | $2,863.67* | -- | -- | 2023 |
| Texas | $255.60* | -- | -- | 2020 |
| Vermont | $2,689.40 | -- | -- | 2026 |
| Wyoming | $3,321.40* | -- | Required | 2026 |
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
- A2001 - Innovamatrix ac, per square centimeter (add-on, list separately in addition to primary procedure)
- 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 107 codes from K0001 to K0864 or every dme & supplies code by number.
Frequently asked questions
How much does Medicaid pay for K0455?
21 state Medicaid programs publish a fee-for-service rate for K0455 (infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol)), ranging from $11.45 in Arizona to $3,429.80 in Montana. The full table on this page lists every publishing state's current rate.
Which state pays the most for K0455?
Montana publishes the highest Medicaid rate for K0455 at $3,429.80. Arizona publishes the lowest at $11.45.
Does K0455 require prior authorization under Medicaid?
2 of the 21 publishing states flag K0455 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".