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K0821 Medicaid reimbursement rates by state

Power wheelchair, group 2 standard, portable. 41 state Medicaid programs publish a fee-for-service rate for K0821. Rates run from $1.00 in Kansas to $4,047.52 in Nebraska, with a median of $345.91.

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

States publishing
41
Median rate
$345.91units vary by state
Highest
$4,047.52Nebraska
Medicare (non-facility)
—not on the physician fee schedule

K0821 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
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$4,047.52⚠ over 3× mediansince 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$3,340.78⚠ over 3× mediansince 2022-06-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services)$2,959.68⚠ over 3× mediansince 2026-01-01——Not classified—South Dakota Medicaid DME fee schedule (
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$2,886.84⚠ over 3× mediansince 2026-01-01——Not classified—Vermont Medicaid Fee Schedule - DME Code
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$2,841.29⚠ over 3× mediansince 2026-07-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$2,823.13⚠ over 3× mediansince 2026-07-01——Plans negotiate; applies out of network—HCA Complex rehab technology fee schedul
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$2,760.12⚠ over 3× mediansince 2026-07-01——Plans negotiate; applies out of network—Durable Medical Equipment and Medical Su
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$2,737.91⚠ 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)$2,494.08since 2017-01-01Each—Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$2,412.69⚠ over 3× mediansince 2025-10-01——Plans negotiate; applies out of network—NC Medicaid fee schedule 'Durable Medica
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$2,358.26⚠ over 3× mediansince 2026-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$2,334.27⚠ over 3× mediansince 2026-05-27——Not classified—DME/POP Fee Schedule (REF-0132-Q)
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$2,307.00⚠ over 3× mediansince 2026-01-01——Plans must pay at least this—SoonerCare Durable Medical Equipment Rat
WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health)$2,052.40⚠ over 3× mediansince 2026-07-01——Not classified—Wyoming Medicaid Downloadable Fee Schedu
MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service)$493.28since 2026-01-01——Not classified—Montana Healthcare Programs fee schedule
AlaskaAny qualified provider (rate does not vary by provider) · Alaska Medicaid (fee-for-service, Department of Health)$493.28since 2026-01-01——Not classified—Alaska Medicaid DMEPOS Interim Fee Sched
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$397.02since 2021-01-01Monthly Rental—Not classified—Durable Medical Equipment Fee Schedule (
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$394.62since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$393.43since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$390.01since 2024-01-01——Plans must pay at least this—DME Fee Schedule for Items that were For
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$345.91since 2024-10-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$343.40since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$328.22since 2026-01-01——Not classified—MaineCare Section 60, Medical Supplies a
DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP)$328.10since 2026-01-01——Plans negotiate; applies out of network—DMAP 2026 DME Fee Schedule
IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$321.95since 2024-07-01——State sets the plan rate—Iowa Medicaid fee schedule #08 PHARMACY
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$318.15since 2026-01-01——State sets the plan rate—KY Medicaid DME fee schedule (2026Medica
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$315.72since 2012-03-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Dmepo
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$310.29since 2026-03-01——Plans negotiate; applies out of network—Rates for Durable Medical Equipment, Oxy
Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service)$297.69since 2012-07-01——Plans negotiate; applies out of network—RI Medicaid Interactive Fee For Service
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$280.11since 2026-04-01——Plans must pay at least this—BMS DME 2026 Non-Rural Fee Schedule Effe
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$278.89since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$264.62since 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)$264.62since 2007-09-24——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$252.64since 2014-02-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$240.73since 2017-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Durable Medic
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$235.21since 2024-07-01——Not classified—SCDHHS Durable Medical Equipment (DME) F
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$170.87since 2018-04-01——Not classified—CMAP fee schedule: 10/01/2026 MEDS - DME
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$11.45since 2026-01-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Durable
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$11.32since 2026-01-01Each—Plans must pay at least this—DMAS procedure fee file hcpcmedical.csv
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$11.30since 2026-10-01day—Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: DME rent
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$1.00since 2006-10-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched

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 K0821?

It depends on the state. Of the 41 states with a published fee-for-service rate, the median is $345.91. Nebraska pays the most ($4,047.52) and Kansas the least ($1.00).

Which state pays the highest Medicaid rate for K0821?

Nebraska, at $4,047.52, effective 2026-07-01.

Do managed-care plans pay the same rate for K0821?

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

L0120Cervical, flexible, non-adjustable, prefabricated · 48 statesL0130Cervical, flexible, thermoplastic collar, molded to patient · 48 statesL0140Cervical, semi-rigid, adjustable (plastic collar) · 48 statesL0150Cervical, semi-rigid, adjustable molded chin cup · 48 statesL0172Cervical, collar, semi-rigid thermoplastic foam, two-piece · 48 statesL0174Cervical, collar, semi-rigid, thermoplastic foam · 48 statesL0200Cervical, multiple post collar · 48 statesL0220Thoracic, rib belt, custom fabricated · 48 statesL0450Tlso, flexible, provides trunk support · 48 statesL0472Tlso, triplanar control, hyperextension · 48 statesL0482Tlso, triplanar control · 48 statesL0484Tlso, triplanar control · 48 states
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Medicaid rates by state
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