K0836 Medicaid reimbursement rate by state (2026)
Power wheelchair, group 2 standard, single power option. Medicaid pays a median of $495.15 for K0836 across 45 states, from $15.21 in Arizona to $5,148.57 in Nebraska.
- States publishing
- 45
- National median
- $495.15units vary by state
- Lowest
- $15.21Arizona
- Highest
- $5,148.57Nebraska
What does Medicaid pay for K0836?
45 state Medicaid programs publish a fee-for-service rate for K0836. The national median is $495.15 (units differ between states). Nebraska pays the most, $5,148.57, and Arizona the least, $15.21 per day, a 338.5x spread.
K0836 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 45 states with every variant, modifier and effective date.
How to read this table
- Order. States are listed from the highest published rate to the lowest. No single unit is shared by 8 or more states for K0836, so the order is by published amount and is not a like-for-like rank.
- Medicaid rate. The most the state's fee-for-service program pays for one unit, as published. 34 of the 45 states list more than one rate for K0836, by modifier, provider type or setting; the table shows the one that matches the provider level and setting used across states, without add-ons.
- Unit. Of the 45 states, 3 publish K0836 per unit, 1 per month and 1 per day, and 40 schedules print no unit at all (a flat amount per service).
- Per hour. K0836 is not billed in time units in these states, so no hourly figure is shown.
- Managed-care plans. The rule the state sets for its plans on this rate. What each rule means is explained below.
- % of Medicare. No Medicare physician fee schedule amount is on file for K0836, so there is no percentage.
- Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.
Why K0836 rates differ between states
Published rates for K0836 run from $15.21 in Arizona to $5,148.57 in Nebraska. The two publish it in different units (no unit printed versus day), so part of that gap is the unit rather than the price. Half the states pay more than the median of $495.15 and half pay less. The usual reasons for a spread like this in equipment & supplies rates:
- A single code can carry separate purchase, rental and used-equipment amounts, and states publish different subsets of them.
- Some items are priced individually from the manufacturer's price or the supplier's invoice, so fewer states publish a fixed fee.
- Many states set equipment and supply fees as a percentage of the Medicare DMEPOS fee schedule, at different percentages and from different years.
Timing matters too. 28 states set the current rate for K0836 in 2026 or later, while 10 states still pay a rate that took effect in 2022 or earlier. A state that has not updated its rate in years will drift down the ranking as others raise theirs.
What managed-care plans pay for K0836
What a plan pays for K0836 is negotiated privately, but the state decides how much room there is to negotiate. Here is how the rules break down across the 45 states.
In 9 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 21 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 15 states is not classified yet.
- Plans negotiate; the published rate applies out of network (21 states). In-network rates can be above or below the published rate. The published rate is the benchmark both sides know, and the fallback if no contract is signed.
- Plans must pay at least the published rate (7 states). The published rate is your floor. Negotiate up from it, and if a plan pays less, the contract provision is the basis for a payment dispute.
- The state sets the plan rate (2 states). There is little to negotiate on price. Contracting is about network participation, authorization and billing terms.
Plan-negotiated rates are never estimated here. To see the rule and its citation for a particular state, open that state's managed-care page, for example Nebraska managed care.
Units and billing for K0836
K0836 is a HCPCS Level II temporary DME code in the equipment & supplies line, billed mostly by durable medical equipment suppliers, orthotists, prosthetists and pharmacies. K codes are temporary codes for durable equipment and supplies, priced like E codes: purchase, rental or used, by modifier.
Units follow the code: per item, per pair, per box or per month of rental, so a per-unit comparison only holds when the states use the same unit. Pricing modifiers decide which amount applies: NU for a new purchase, RR for a monthly rental and UE for used equipment.
Before billing, confirm the rate, unit and any modifier with the state's current schedule or the plan: the amounts here are as published, not a guarantee of payment.
Frequently asked questions
What does Medicaid pay for K0836?
It depends on the state. Of the 45 states with a published fee-for-service rate, the median is $495.15. Nebraska pays the most ($5,148.57) and Arizona the least ($15.21 per day).
Which state pays the highest Medicaid rate for K0836?
Nebraska, at $5,148.57, effective 2026-07-01.
Which state pays the lowest Medicaid rate for K0836?
Arizona, at $15.21 per day, effective 2026-10-01. It publishes the code in a different unit from Nebraska, so compare per unit with care.
What unit is K0836 billed in?
Of the 45 states, 3 publish K0836 per unit, 1 per month and 1 per day, and 40 schedules print no unit at all (a flat amount per service).
Do managed-care plans pay the same rate for K0836?
Not necessarily. In 9 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 21 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 15 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.