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K0842 Medicaid reimbursement rates by state

Power wheelchair, group 2 standard, multiple power option. 24 state Medicaid programs publish a fee-for-service rate for K0842. Rates run from $16.51 in Arizona to $5,284.52 in Nebraska, with a median of $505.64.

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

States publishing
24
Median rate
$505.64units vary by state
Highest
$5,284.52Nebraska
Medicare (non-facility)
—not on the physician fee schedule

K0842 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)$5,284.52⚠ 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)$4,361.79⚠ over 3× mediansince 2022-06-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$3,603.66⚠ 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)$3,574.61⚠ over 3× mediansince 2019-07-24——Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2019-07-
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$3,370.93⚠ 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)$3,362.29since 2023-01-01Each—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)$3,256.42since 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)$3,150.05⚠ 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)$2,456.62⚠ 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)$524.92since 2020-01-01Monthly Rental—Not classified—Durable Medical Equipment Fee Schedule (
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$518.87since 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)$505.64since 2026-01-01——State sets the plan rate—KY Medicaid DME fee schedule (2026Medica
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$505.64since 2026-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$505.64since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$478.01since 2026-03-01——Plans negotiate; applies out of network—Rates for Durable Medical Equipment, Oxy
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$456.26since 2024-10-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$429.79since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$421.15since 2012-03-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Dmepo
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$359.88since 2017-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Durable Medic
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$353.95since 2026-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$345.49since 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)$345.49since 2007-09-24——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$16.85since 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)$16.51since 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 K0842?

It depends on the state. Of the 24 states with a published fee-for-service rate, the median is $505.64. Nebraska pays the most ($5,284.52) and Arizona the least ($16.51 per day).

Which state pays the highest Medicaid rate for K0842?

Nebraska, at $5,284.52, effective 2026-07-01.

Do managed-care plans pay the same rate for K0842?

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.

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