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E0580 Medicaid reimbursement rates by state

Nebulizer, durable, glass or autoclavable plastic. 20 state Medicaid programs publish a fee-for-service rate for E0580 at the nurse midwife level. Rates run from $5.36 in Nebraska to $171.79 in Arizona, with a median of $15.30.

Data as of 2026-10-05. Every rate links to the official document it came from.

States publishing
20
Median rate
$15.30units vary by state
Highest
$171.79Arizona
Medicare (non-facility)
—not on the physician fee schedule

E0580 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.

StateMedicaid rateUnitPer hourManaged-care plans% of MedicareSource
ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$171.79⚠ over 3× mediansince 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$164.65⚠ over 3× mediansince 2026-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$157.64⚠ over 3× mediansince 2024-01-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Durable
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$148.19since 2026-01-01Each—Plans must pay at least this—DMAS procedure fee file hcpcmedical.csv
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$127.50⚠ over 3× mediansince 2024-01-01——Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2024-01-
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$121.31⚠ over 3× mediansince 2020-01-01——State sets the plan rate—KY Medicaid DME fee schedule (2020Medica
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$115.00since 2006-04-01Each—Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$106.43⚠ over 3× mediansince 2022-06-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$100.48⚠ over 3× mediansince 2026-03-01——Plans negotiate; applies out of network—Rates for Durable Medical Equipment, Oxy
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$16.15since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$14.45since 2012-07-01——Plans must pay at least this—Louisiana Medicaid Durable Medical Equip
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$14.00since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$13.83since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$12.80since 2024-07-01——State sets the plan rate—Iowa Medicaid fee schedule #08 PHARMACY
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$12.62since 2024-10-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$11.89since 2013-04-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Dmepo
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$9.70since 2026-05-20——Not classified—EPSDT Referral (DME) Fee Schedule (REF-0
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$8.45since 2018-04-01——Not classified—CMAP fee schedule: 10/01/2026 MEDS - DME
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$5.37since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$5.36since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5

Rates marked ⚠ are more than three times the median for the same unit; they are published as shown but often reflect an office (non-facility) fee or a different scope of service. 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 E0580?

It depends on the state. Of the 20 states with a published fee-for-service rate, the median is $15.30. Arizona pays the most ($171.79) and Nebraska the least ($5.36).

Which state pays the highest Medicaid rate for E0580?

Arizona, at $171.79, effective 2026-10-01.

Do managed-care plans pay the same rate for E0580?

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.

Related Equipment & supplies codes

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