E0491 Medicaid reimbursement rates by state
Oral device/appliance for neuromuscular electrical.... 5 state Medicaid programs publish a fee-for-service rate for E0491. Rates run from $14.75 in New Jersey to $85.75 in Massachusetts, with a median of $80.70.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 5
- Median rate
- $80.70units vary by state
- Highest
- $85.75Massachusetts
- Medicare (non-facility)
- —not on the physician fee schedule
E0491 rate in every state
One like-for-like fee-for-service rate per state, highest first. Units can differ between states; the per-hour column converts time-based units.
| State | Medicaid rate | Unit | Per hour | Managed-care plans | % of Medicare | Source |
|---|---|---|---|---|---|---|
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $85.75since 2026-03-01 | — | — | Plans negotiate; applies out of network | — | Rates for Durable Medical Equipment, Oxy |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $82.64since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | ODM DMEPOS combined payment schedules (a |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $80.70since 2025-01-01 | — | — | Plans negotiate; applies out of network | — | Durable Medical Equipment Services Fee S |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $78.69since 2024-04-01 | — | — | Not classified | — | SCDHHS Durable Medical Equipment (DME) F |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $14.75since 2026-07-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
Rates are per the unit shown for each state; units can differ between states. Medicare amounts are computed from the CMS relative value file and locality cost indices with the CMS formula; states with several Medicare localities show a range. Confirm rates with the payer before billing.
Frequently asked questions
What does Medicaid pay for E0491?
It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $80.70. Massachusetts pays the most ($85.75) and New Jersey the least ($14.75).
Which state pays the highest Medicaid rate for E0491?
Massachusetts, at $85.75, effective 2026-03-01.
Do managed-care plans pay the same rate for E0491?
Not necessarily. Each state's plan contracts decide whether plans must pay at least the fee-for-service rate, pay a state-set rate, or negotiate their own. The table shows the rule for each state, cited to the contract or statute.