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An update on Medicaid reimbursement by state
February 5, 2001
Table on Medicaid dispensing fees by state
MANAGED CARE
An update on Medicaid reimbursement by state
How does your state Medicaid dispensing fee stack up against that of other states? The following table provides a rundown. Some states did not submit their 2000 information, so their 1999 data are listed.
| State | Dispensing fees | Ingredient reimbursement basis | Co-pay | Year |
| Alabama | $5.40 | AWP-10%; WAC+9.2% | $0.50 - $3.00 | 2000 |
| Alaska | $3.45 | AWP-5% | $2.00 | 2000 |
| Arizona* | AWP-10% | 1999 | ||
| Arkansas | $5.51 | AWP-10.5% | $0.50 - $3.00 | 2000 |
| California | $4.05 | AWP-5% | G: $1.00, B: $1.00 | 2000 |
| Colorado | $4.08 | AWP-10% or WAC+18% (whichever is lowest) | G: $0.50, B: $2.00 | 2000 |
| Connecticut | $4.10 | AWP-12% | No | 2000 |
| Delaware | $3.65 | AWP-12.9% | No | 2000 |
| District of Columbia | $3.75 | AWP-10% | $1.00 | 1999 |
| Florida | $4.23 | AWP-13.25% | No | 2000 |
| Georgia | $4.63 | AWP-10% | $0.50 | 2000 |
| Hawaii | $4.67 | AWP-10.5% | No | 2000 |
| Idaho | $4.94 ($5.54 for unit dose) | AWP-11% | No | 2000 |
| Illinois | G: $3.75, B: $3.45 | AWP-10%, AWP-12% (for multisource drugs) | No | 2000 |
| Indiana | $4.00 | AWP-10% | $0.50 - $3.00 | 2000 |
| Iowa | $4.13 - $6.42 | AWP-10% | $1.00 | 2000 |
| Kansas | $4.50 | AWP-10% | $2.00 | 2000 |
| Kentucky | OP: $4.75, LTC: $5.75 | AWP-10% | No | 2000 |
| Louisiana | $5.77 | AWP-10.5% | $0.50 - $3.00 | 1999 |
| Maine | $3.35 (+ extra fees for compounding) | AWP-10% | $0.50 - $3.00 | 1999 |
| Maryland | $4.21 | Lowest of :WAC + 10%, direct + 10%, AWP -10% | $1.00 | 2000 |
| Massachusetts | $3.00 | WAC+10% | $0.50 | 2000 |
| Michigan | $3.72 | AWP-13.5% (1 to 4 stores), $1.00 AWP-15.1% (5+ stores) | $1.00 | 2000 |
| Minnesota | $3.65 | AWP-9% | No | 2000 |
| Mississippi | $4.91 | AWP-10% | $1.00 | 2000 |
| Missouri | $4.09 | AWP-10.43% | $0.50 - $2.00 | 2000 |
| Montana | $2.00 - $4.20 | AWP-10% | G: $1.00, B: $2.00 | 2000 |
| Nebraska | $3.20 - $5.05 | AWP-8.71% | $1.00 | 2000 |
| Nevada | $4.76 | AWP-10% | No | 2000 |
| New Hampshire | $2.50 | AWP-12% | G: $0.50, B: $1.00 | 2000 |
| New Jersey | $3.73 - $4.07 | AWP-10% | No | 2000 |
| New Mexico | $4.00 | AWP-12.5% | No | 1999 |
| New York | B: $3.50 G: $4.50 | AWP-10% | G: $0.50, B: $2.00 | 2000 |
| North Carolina | $5.60 | AWP-10% | $1.00 | 2000 |
| North Dakota | $4.60 | AWP-10% | No | 1999 |
| Ohio | $3.70 | AWP-11% | No | 2000 |
| Oklahoma | $4.15 | AWP-10.5% | $1.00 - $2.00 | 2000 |
| Oregon | $3.91-$4.28 (based on annual # of Rxs) | AWP-11% | No | 2000 |
| Pennsylvania | $4.00 | AWP-10% | $1.00 - $2.00 | 2000 |
| Rhode Island | OP: $3.40, LTC: $2.85 | WAC+5% | No | 1999 |
| South Carolina | $4.05 | AWP-10% | $2.00 | 2000 |
| South Dakota | $4.75 ($5.55 for unit dose) | AWP-10.5% | $2.00 | 2000 |
| Tennessee* | 1999 | |||
| Texas | $5.27 + 2% (of ingredient & dispensing fee) | AWP-15% or WAC+12% (whichever is lowest) | No | 2000 |
| Utah | $3.90 - $4.40 (based on geographic area) | AWP-12% | $1.00 - $5.00 | 1999 |
| Vermont | $4.25 | AWP-11.9% | $1.00 - $2.00 | 2000 |
| Virginia | $4.25 | AWP-9% | $1.00 | 1999 |
| Washington | $4.06 - $5.02 (based on annual # of Rxs) | AWP-11% | No | 2000 |
| West Virginia | $3.90 (+ extra fees for compounding) | AWP-12% | $0.50 - $2.00 | 2000 |
| Wisconsin | $4.88 | AWP-10% | $0.50 - $1.00 | 2000 |
| Wyoming | $4.70 | AWP-4% | $2.00 | 2000 |
An update on Medicaid reimbursement by state. Drug Topics 2001;3:79.