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E1237 Medicaid reimbursement rates by state

Wheelchair, pediatric size, rigid, adjustable. 23 state Medicaid programs publish a fee-for-service rate for E1237. Rates run from $7.69 in Arizona to $2,355.70 in Washington, with a median of $192.38.

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

States publishing
23
Median rate
$192.38units vary by state
Highest
$2,355.70Washington
Medicare (non-facility)
—not on the physician fee schedule

E1237 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
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$2,355.70⚠ over 3× mediansince 2026-07-01——Plans negotiate; applies out of network—HCA Complex rehab technology fee schedul
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$2,226.13since 2026-01-01Each—Plans must pay at least this—DMAS procedure fee file hcpcmedical.csv
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$1,651.32since 2017-01-01Each—Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$1,418.98⚠ over 3× mediansince 2026-07-01——Plans negotiate; applies out of network—Durable Medical Equipment and Medical Su
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$1,205.77⚠ 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)$1,091.00⚠ over 3× mediansince 2024-07-01——Not classified—SCDHHS Durable Medical Equipment (DME) F
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$235.57since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$235.57since 2026-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$235.57since 2026-01-01——State sets the plan rate—KY Medicaid DME fee schedule (2026Medica
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$206.13since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$200.23since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$192.38since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$191.71since 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)$165.30since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$163.16since 2022-04-20——Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2022-04-
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$161.67since 2025-12-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$145.99since 2023-01-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$143.94since 2012-03-01——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)$132.24since 2016-07-01——Plans negotiate; applies out of network—DME Fee Schedule - Excel.xlsx
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$125.63since 2012-09-10——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$111.43since 2021-09-01——Plans must pay at least this—Louisiana Medicaid Durable Medical Equip
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$7.85since 2026-01-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Durable
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$7.69since 2026-10-01day—Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: DME rent

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 E1237?

It depends on the state. Of the 23 states with a published fee-for-service rate, the median is $192.38. Washington pays the most ($2,355.70) and Arizona the least ($7.69 per day).

Which state pays the highest Medicaid rate for E1237?

Washington, at $2,355.70, effective 2026-07-01.

Do managed-care plans pay the same rate for E1237?

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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