E1226 Medicaid reimbursement rates by state
Wheelchair accessory, manual fully reclining back,. 25 state Medicaid programs publish a fee-for-service rate for E1226 at the nurse midwife level. Rates run from $1.62 in Wisconsin to $605.65 in Washington, with a median of $270.75.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 25
- Median rate
- $270.75units vary by state
- Highest
- $605.65Washington
- Medicare (non-facility)
- —not on the physician fee schedule
E1226 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 |
|---|---|---|---|---|---|---|
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $605.65⚠ over 3× mediansince 2021-07-01 | — | — | Plans negotiate; applies out of network | — | HCA Complex rehab technology fee schedul |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $481.68⚠ over 3× mediansince 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $470.76⚠ over 3× mediansince 2018-07-01 | — | — | Plans negotiate; applies out of network | — | MO HealthNet fee schedule: Durable Medic |
| ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $467.60⚠ over 3× mediansince 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Durable |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $463.32since 2017-01-01 | Each | — | Plans negotiate; applies out of network | — | ODM DMEPOS combined payment schedules (a |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $449.58since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $422.08since 2026-01-01 | Each | — | Plans must pay at least this | — | DMAS procedure fee file hcpcmedical.csv |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $407.60⚠ over 3× mediansince 2012-12-28 | — | — | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $379.73⚠ over 3× mediansince 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Durable Medical Equipment and Medical Su |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $367.83⚠ over 3× mediansince 2021-09-01 | — | — | Plans must pay at least this | — | Louisiana Medicaid Durable Medical Equip |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $338.27⚠ over 3× mediansince 2025-10-01 | — | — | Plans negotiate; applies out of network | — | NC Medicaid fee schedule 'Durable Medica |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $289.33⚠ over 3× mediansince 2024-07-01 | — | — | Not classified | — | SCDHHS Durable Medical Equipment (DME) F |
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $270.75since 2026-07-01 | Used Purchase | — | Not classified | — | Durable Medical Equipment Fee Schedule ( |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $263.45⚠ over 3× mediansince 2026-03-01 | — | — | Plans negotiate; applies out of network | — | Rates for Durable Medical Equipment, Oxy |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $53.85since 2022-04-20 | — | — | Plans negotiate; applies out of network | — | HFS DME Fee Schedule (effective 2022-04- |
| New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service) | $49.60since 2022-06-01 | — | — | Plans negotiate; applies out of network | — | eMedNY NYS Medicaid DMEPOS Fee Schedule |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $48.19since 2023-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Medical Suppliers/Orthotists/Prost |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $48.17since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP) | $45.78since 2026-09-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Dmepo |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $44.93since 2016-07-01 | — | — | Plans negotiate; applies out of network | — | DME Fee Schedule - Excel.xlsx |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $38.70since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $38.58since 2020-01-01 | — | — | State sets the plan rate | — | KY Medicaid DME fee schedule (2020Medica |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $35.65since 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) | $35.23since 2026-07-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $1.62since 2008-07-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Durable |
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 E1226?
It depends on the state. Of the 25 states with a published fee-for-service rate, the median is $270.75. Washington pays the most ($605.65) and Wisconsin the least ($1.62).
Which state pays the highest Medicaid rate for E1226?
Washington, at $605.65, effective 2021-07-01.
Do managed-care plans pay the same rate for E1226?
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
A7000Canister, disposable, used with suction pump, each · 25 statesA7005Administration set, with small volume nonfiltered pneumatic... · 25 statesA8000Helmet, protective, soft, prefabricated · 25 statesA8001Helmet, protective, hard, prefabricated · 25 statesB9002Enteral nutrition infusion pump, any type · 25 statesE0105Cane, quad or three prong, includes canes of all materials · 25 statesE0130Walker, rigid (pickup), adjustable or fixed height · 25 statesE0135Walker, folding (pickup), adjustable or fixed height · 25 statesE0141Durable medical equipment · 25 statesE0143Walker, folding, wheeled, adjustable or fixed height · 25 statesE0149Walker, heavy duty, wheeled, rigid or folding, any type · 25 statesE0154Platform attachment, walker, each · 25 states
Track E1226 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.