Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for E0243. Full schedules include every locality, modifier, and age-band variant.
- Every code on all 51 published schedules
- Full-schedule CSV export and state network lists
- Email alerts when a state changes its rates
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Publishing states
24
Median % of Medicare
--
Rate range
$5.41 - $71.56
E0243 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| California | $42.76 | -- | -- | 2026 |
| Colorado | $37.45 | -- | Required | 2026 |
| Connecticut | $52.00 | -- | -- | 2003 |
| District of Columbia | $44.00 | -- | Varies | 2015 |
| Georgia | $33.10* | -- | -- | 2026 |
| Hawaii | $5.41 | -- | -- | 2025 |
| Illinois | $30.30 | -- | -- | 2026 |
| Indiana | $53.83* | -- | -- | 2026 |
| Kentucky | $36.38 | -- | -- | 2026 |
| Louisiana | $46.22 | -- | -- | 2026 |
| Massachusetts | $38.14 | -- | -- | 2026 |
| Maine | $32.30 | -- | -- | 2026 |
| Michigan | $40.00* | -- | -- | 2026 |
| Nebraska | $71.56* | -- | -- | 2026 |
| New York | $36.23 | -- | -- | 2026 |
| Ohio | $40.00 | -- | Not required | 1999 |
| Oklahoma | $15.00 | -- | -- | 2020 |
| Pennsylvania | $39.50* | -- | -- | 2012 |
| South Carolina | $32.57* | -- | -- | 2003 |
| Texas | $61.50* | -- | -- | 2017 |
| Vermont | $37.24 | -- | -- | 2026 |
| Wisconsin | $17.72 | -- | -- | 2008 |
| West Virginia | $28.35 | -- | -- | 2026 |
| Wyoming | $53.63 | -- | -- | 2021 |
Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Rows marked * are representative published variants or methodology-derived rates. "--" in the prior-auth column means the state publishes no PA flag.
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All 295 codes from E0100 to E0995 or every dme & supplies code by number.
Frequently asked questions
How much does Medicaid pay for E0243?
24 state Medicaid programs publish a fee-for-service rate for E0243 (toilet rail, each), ranging from $5.41 in Hawaii to $71.56 in Nebraska. The full table on this page lists every publishing state's current rate.
Which state pays the most for E0243?
Nebraska publishes the highest Medicaid rate for E0243 at $71.56. Hawaii publishes the lowest at $5.41.
Does E0243 require prior authorization under Medicaid?
1 of the 24 publishing states flag E0243 as requiring prior authorization (always or conditionally) on their fee schedules. States without a flag publish no PA indicator for this code - that means "not published", not "no PA required".