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E0986 Medicaid reimbursement rates by state

Manual wheelchair accessory, power assist system. 21 state Medicaid programs publish a fee-for-service rate for E0986 at the nurse midwife level. Rates run from $327.90 in Louisiana to $6,932.40 in Wisconsin, with a median of $693.24.

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

States publishing
21
Median rate
$693.24units vary by state
Highest
$6,932.40Wisconsin
Medicare (non-facility)
—not on the physician fee schedule

E0986 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
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$6,932.40⚠ over 3× mediansince 2026-01-01——State sets the plan rate—ForwardHealth max fee schedule: Durable
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$6,551.16since 2026-01-01Each—Plans must pay at least this—DMAS procedure fee file hcpcmedical.csv
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$5,952.20⚠ over 3× mediansince 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$5,797.14⚠ over 3× mediansince 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$5,618.06⚠ over 3× mediansince 2022-07-01——Not classified—Health First Colorado Physician Fee Sche
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$5,219.33⚠ over 3× mediansince 2026-07-01——Plans negotiate; applies out of network—Durable Medical Equipment and Medical Su
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$5,210.23⚠ over 3× mediansince 2021-07-01——Plans negotiate; applies out of network—HCA Complex rehab technology fee schedul
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$4,671.37⚠ over 3× mediansince 2019-07-24——Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2019-07-
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$4,255.42since 2017-01-01Each—Plans negotiate; applies out of network—ODM wheelchair payment schedule (subject
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$4,231.20⚠ over 3× mediansince 2026-02-01——Not classified—SCDHHS Durable Medical Equipment (DME) F
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$693.24since 2026-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$679.65since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$595.12since 2023-01-01——State sets the plan rate—KY Medicaid DME fee schedule (2023Medica
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$589.25since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$564.16since 2026-03-01——Plans negotiate; applies out of network—Rates for Durable Medical Equipment, Oxy
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$486.43since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$448.06since 2019-08-19——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$417.60since 2019-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Durable Medic
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$412.98since 2023-01-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$389.14since 2016-07-01——Plans negotiate; applies out of network—DME Fee Schedule - Excel.xlsx
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$327.90since 2021-09-01——Plans must pay at least this—Louisiana Medicaid Durable Medical Equip

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 E0986?

It depends on the state. Of the 21 states with a published fee-for-service rate, the median is $693.24. Wisconsin pays the most ($6,932.40) and Louisiana the least ($327.90).

Which state pays the highest Medicaid rate for E0986?

Wisconsin, at $6,932.40, effective 2026-01-01.

Do managed-care plans pay the same rate for E0986?

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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