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K0858 Medicaid reimbursement rates by state

Power wheelchair, group 3 heavy duty, single power option. 30 state Medicaid programs publish a fee-for-service rate for K0858. Rates run from $42.33 in Arizona to $8,644.40 in Washington, with a median of $1,171.81.

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

States publishing
30
Median rate
$1,171.81units vary by state
Highest
$8,644.40Washington
Medicare (non-facility)
—not on the physician fee schedule

K0858 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$8,644.40⚠ over 3× mediansince 2026-07-01——Plans negotiate; applies out of network—HCA Complex rehab technology fee schedul
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$8,644.40⚠ 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)$8,644.40⚠ 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)$8,644.40⚠ over 3× mediansince 2026-01-01——Plans must pay at least this—SoonerCare Durable Medical Equipment Rat
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$8,611.67⚠ over 3× mediansince 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$8,168.97since 2026-01-01Each—Plans must pay at least this—DMAS procedure fee file hcpcmedical.csv
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$7,107.98⚠ 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)$5,872.46⚠ 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)$5,825.21⚠ 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)$5,306.56since 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)$5,133.32⚠ 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)$3,602.97⚠ over 3× mediansince 2024-07-01——Not classified—SCDHHS Durable Medical Equipment (DME) F
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$1,296.66since 2026-01-01——State sets the plan rate—KY Medicaid DME fee schedule (2026Medica
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$1,296.66since 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)$1,241.45since 2026-03-01——Plans negotiate; applies out of network—Rates for Durable Medical Equipment, Oxy
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$1,102.16since 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)$1,058.94since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$913.71since 2024-10-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$907.66since 2026-01-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$728.73since 2024-10-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$703.76since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$686.31since 2012-03-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Dmepo
IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$685.00since 2024-07-01——State sets the plan rate—Iowa Medicaid fee schedule #08 PHARMACY
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$601.71since 2013-03-01——Not classified—CMAP fee schedule: 10/01/2026 MEDS - DME
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$595.27since 2019-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Durable Medic
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$563.01since 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)$563.01since 2007-09-24——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$500.00since 2006-10-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$43.22since 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)$42.33since 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 K0858?

It depends on the state. Of the 30 states with a published fee-for-service rate, the median is $1,171.81. Washington pays the most ($8,644.40) and Arizona the least ($42.33 per day).

Which state pays the highest Medicaid rate for K0858?

Washington, at $8,644.40, effective 2026-07-01.

Do managed-care plans pay the same rate for K0858?

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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