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E1285 Medicaid reimbursement rates by state

Heavy duty wheelchair, fixed full length arms. 14 state Medicaid programs publish a fee-for-service rate for E1285 at the physician psychologist level. Rates run from $60.42 in Louisiana to $1,396.58 in Arizona, with a median of $108.00.

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

States publishing
14
Median rate
$108.00units vary by state
Highest
$1,396.58Arizona
Medicare (non-facility)
—not on the physician fee schedule

E1285 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
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$1,396.58⚠ over 3× mediansince 2021-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$1,270.00⚠ over 3× mediansince 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)$1,051.02since 2017-01-01Each—Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$525.58since 2010-07-01Each—Plans negotiate; applies out of network—DMAS procedure fee file hcpcmedical.csv
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$432.87⚠ over 3× mediansince 2020-08-01——Plans must pay at least this—SoonerCare Durable Medical Equipment Rat
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$119.96since 2014-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$110.66since 2026-07-01——Not classified—Health First Colorado Physician Fee Sche
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$105.34since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$101.61since 2010-06-14——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$100.79since 2026-09-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Dmepo
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$98.07since 2020-01-01——State sets the plan rate—KY Medicaid DME fee schedule (2020Medica
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$79.90since 2026-05-27——Not classified—DME/POP Fee Schedule (REF-0132-Q)
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$72.79since 2024-10-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$60.42since 2012-07-01——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 E1285?

It depends on the state. Of the 14 states with a published fee-for-service rate, the median is $108.00. Arizona pays the most ($1,396.58) and Louisiana the least ($60.42).

Which state pays the highest Medicaid rate for E1285?

Arizona, at $1,396.58, effective 2021-10-01.

Do managed-care plans pay the same rate for E1285?

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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