An update on Medicaid reimbursement by state
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.
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