Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for E0472. 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
36
Median % of Medicare
--
Rate range
$16.03 - $6,164.88
E0472 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $4,786.00 | -- | -- | 2026 |
| Arkansas | $16.19* | -- | -- | 2026 |
| Arizona | $16.03* | -- | -- | 2026 |
| California | $6,164.88 | -- | -- | 2026 |
| Colorado | $5,324.77* | -- | Required | 2026 |
| Connecticut | $3,290.30 | -- | Required | 2018 |
| Florida | $446.92 | -- | -- | 2026 |
| Iowa | $521.49* | -- | -- | 2024 |
| Idaho | $5,803.32* | -- | Required | 2026 |
| Illinois | $3,943.30 | -- | -- | 2026 |
| Indiana | $5,199.30* | -- | -- | 2025 |
| Kansas | $434.19* | -- | -- | 2026 |
| Kentucky | $4,432.00 | -- | -- | 2026 |
| Massachusetts | $388.38* | -- | -- | 2026 |
| Maryland | $3,725.80 | -- | Required | 2026 |
| Maine | $671.68* | -- | -- | 2026 |
| Minnesota | $5,427.40 | -- | Conditional | 2026 |
| Mississippi | $16.87* | -- | -- | 2026 |
| Nebraska | $531.26* | -- | -- | 2026 |
| New Hampshire | $106.30 | -- | Required | 2026 |
| New Jersey | $298.77 | -- | Required | 2026 |
| New Mexico | $480.86 | -- | -- | 2025 |
| Nevada | $520.91* | -- | -- | 2017 |
| New York | $191.90 | -- | -- | 2026 |
| Ohio | $320.00 | -- | Not required | 2006 |
| Oklahoma | $612.28 | -- | -- | 2026 |
| Pennsylvania | $436.67* | -- | -- | 2005 |
| South Carolina | $507.35* | -- | -- | 2024 |
| Texas | $397.03* | -- | -- | 2017 |
| Utah | $345.55* | -- | Not required | 2026 |
| Virginia | $16.16 | -- | -- | 2026 |
| Vermont | $5,895.23 | -- | -- | 2026 |
| Washington | $528.26* | -- | -- | 2026 |
| Wisconsin | $5,339.70 | -- | -- | 2026 |
| West Virginia | $537.34 | -- | -- | 2026 |
| Wyoming | $4,701.50* | -- | Required | 2026 |
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.
Related dme & supplies codes
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- A2002 - Mirragen advanced wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)
- A2005 - Microlyte matrix, per square centimeter (add-on, list separately in addition to primary procedure)
- A2006 - Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)
- A2007 - Restrata, per square centimeter (add-on, list separately in addition to primary procedure)
- A2008 - Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)
- A2009 - Symphony, per square centimeter (add-on, list separately in addition to primary procedure)
- A2010 - Apis, per square centimeter (add-on, list separately in addition to primary procedure)
All 295 codes from E0100 to E0995 or every dme & supplies code by number.
Frequently asked questions
How much does Medicaid pay for E0472?
36 state Medicaid programs publish a fee-for-service rate for E0472 (respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)), ranging from $16.03 in Arizona to $6,164.88 in California. The full table on this page lists every publishing state's current rate.
Which state pays the most for E0472?
California publishes the highest Medicaid rate for E0472 at $6,164.88. Arizona publishes the lowest at $16.03.
Does E0472 require prior authorization under Medicaid?
8 of the 36 publishing states flag E0472 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".