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An update on Medicaid reimbursement by state
Table on Medicaid dispensing fees by state
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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.
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