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E0655 Medicaid reimbursement rates by state

Non-segmental pneumatic appliance for use with pneumatic.... 41 state Medicaid programs publish a fee-for-service rate for E0655 at the nurse midwife level. Rates run from $0.42 in Wisconsin to $162.70 in Wyoming, with a median of $79.10.

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

States publishing
41
Median rate
$79.10units vary by state
Highest
$162.70Wyoming
Medicare (non-facility)
—not on the physician fee schedule

E0655 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
WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health)$162.70since 2026-07-01——Not classified—Wyoming Medicaid Downloadable Fee Schedu
ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$160.49since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$153.82since 2026-07-01——Plans negotiate; applies out of network—HCA Medical equipment and supplies fee s
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$148.34since 2026-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$138.44since 2026-01-01Each—Plans must pay at least this—DMAS procedure fee file hcpcmedical.csv
South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services)$138.44since 2026-01-01——Not classified—South Dakota Medicaid DME fee schedule (
AlaskaAny qualified provider (rate does not vary by provider) · Alaska Medicaid (fee-for-service, Department of Health)$134.75since 2026-01-01——Not classified—Alaska Medicaid DMEPOS Interim Fee Sched
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$132.90since 2026-07-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$123.06since 2026-07-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$123.06since 2026-04-01——Plans must pay at least this—BMS DME 2026 Rural Fee Schedule Effectiv
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$121.55since 2026-01-01——Not classified—Vermont Medicaid Fee Schedule - DME Code
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$115.30since 2022-07-01——Not classified—Health First Colorado Physician Fee Sche
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$108.75since 2026-01-01——Not classified—MaineCare Section 60, Medical Supplies a
District of ColumbiaAny qualified provider (rate does not vary by provider) · DC Medicaid (DHCF) fee-for-service$104.60since 2026-04-01——Not classified—REFRP00178CSV - Medical Fee Schedule Rep
DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP)$98.18since 2026-01-01——Plans negotiate; applies out of network—DMAP 2026 Physician Fee Schedule
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$97.91since 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)$93.23since 2020-01-01——State sets the plan rate—KY Medicaid DME fee schedule (2020Medica
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$92.27since 2024-07-01——Not classified—SCDHHS Durable Medical Equipment (DME) F
NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$89.60since 2017-01-01——Plans negotiate; applies out of network—Provider Type 33, Durable Medical Equipm
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$88.50since 2026-03-01——Plans negotiate; applies out of network—Rates for Durable Medical Equipment, Oxy
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$79.10since 2026-07-01——Plans negotiate; applies out of network—Durable Medical Equipment and Medical Su
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$77.50since 1994-01-01Each—Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service)$74.87since 2009-03-01——Plans negotiate; applies out of network—RI Medicaid Interactive Fee For Service
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$70.46since 2025-10-01——Plans negotiate; applies out of network—NC Medicaid fee schedule 'Durable Medica
IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$64.09since 2024-07-01——State sets the plan rate—Iowa Medicaid fee schedule #08 PHARMACY
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$56.60since 2022-06-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$18.08since 2026-01-01——Plans must pay at least this—SoonerCare Durable Medical Equipment Rat
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$17.73since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$15.82since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service)$15.37since 2026-01-01——Not classified—Montana Healthcare Programs fee schedule
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$15.16since 2021-01-01——Not classified—2026 Fee Schedule - Covered Procedures R
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$15.07since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$12.84since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$12.68since 2012-10-03——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$12.52since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$10.78since 2007-05-01——Not classified—CMAP fee schedule: 10/01/2026 MEDS - DME
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$10.46since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$9.71since 2023-04-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$8.66since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$8.48since 2013-04-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Dmepo
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$0.42since 2008-07-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Durable

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 E0655?

It depends on the state. Of the 41 states with a published fee-for-service rate, the median is $79.10. Wyoming pays the most ($162.70) and Wisconsin the least ($0.42).

Which state pays the highest Medicaid rate for E0655?

Wyoming, at $162.70, effective 2026-07-01.

Do managed-care plans pay the same rate for E0655?

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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