State-Specific Services codes T4521 to T4544 with Medicaid rates by state

23 state-specific services codes from T4521 to T4544 carry a published Medicaid rate in ten or more states. The median shown is across those states' unmodified published rates; open a code for the full state-by-state table with percent of Medicare and prior-authorization flags.

CodeDescriptionStatesMedian rate
T4521Adult sized disposable incontinence product, brief/diaper, small, each40$0.62
T4522Adult sized disposable incontinence product, brief/diaper, medium, each40$0.63
T4523Adult sized disposable incontinence product, brief/diaper, large, each39$0.80
T4524Adult sized disposable incontinence product, brief/diaper, extra large, each39$0.90
T4525Adult sized disposable incontinence product, protective underwear/pull-on, small size, each35$0.70
T4526Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each36$0.78
T4527Adult sized disposable incontinence product, protective underwear/pull-on, large size, each35$0.87
T4528Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each36$0.90
T4529Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each37$0.51
T4530Pediatric sized disposable incontinence product, brief/diaper, large size, each37$0.55
T4531Pediatric sized disposable incontinence product, protective underwear/pull-on, small/medium size, each34$0.70
T4532Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each35$0.63
T4533Youth sized disposable incontinence product, brief/diaper, each35$0.58
T4534Youth sized disposable incontinence product, protective underwear/pull-on, each34$0.79
T4535Disposable liner/shield/guard/pad/undergarment, for incontinence, each33$0.39
T4536Incontinence product, protective underwear/pull-on, reusable, any size, each15$8.00
T4537Incontinence product, protective underpad, reusable, bed size, each21$13.17
T4539Incontinence product, diaper/brief, reusable, any size, each15$6.72
T4540Incontinence product, protective underpad, reusable, chair size, each16$9.93
T4541Incontinence product, disposable underpad, large, each24$0.38
T4542Incontinence product, disposable underpad, small size, each19$0.34
T4543Adult sized disposable incontinence product, protective brief/diaper, above extra large, each35$1.45
T4544Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each30$1.35

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. Descriptions are ProviderSignal's own plain-language labels or public-domain CMS text.