Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for E0657. 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
$29/mo after the trial. Cancel anytime.
Publishing states
22
Median % of Medicare
--
Rate range
$36.66 - $773.70
E0657 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arizona | $488.82 | -- | -- | 2012 |
| California | $474.81 | -- | -- | 2026 |
| Colorado | $618.95 | -- | Required | 2026 |
| Connecticut | $459.71 | -- | Required | 2013 |
| District of Columbia | $61.90* | -- | Not required | 2026 |
| Iowa | $548.63 | -- | -- | 2024 |
| Illinois | $556.56 | -- | -- | 2026 |
| Indiana | $758.50* | -- | -- | 2026 |
| Kentucky | $66.41 | -- | -- | 2026 |
| Massachusetts | $62.96* | -- | -- | 2026 |
| Michigan | $635.41 | -- | -- | 2026 |
| Minnesota | $773.70 | -- | Conditional | 2026 |
| Montana | $773.70 | -- | Varies | 2026 |
| Nebraska | $706.59* | -- | -- | 2026 |
| New Hampshire | $36.66 | -- | Required | 2026 |
| New Mexico | $629.12 | -- | -- | 2025 |
| New York | $577.52 | -- | -- | 2026 |
| Ohio | $606.80 | -- | -- | 2026 |
| South Carolina | $62.50* | -- | -- | 2024 |
| Virginia | $731.09 | -- | -- | 2026 |
| Wisconsin | $349.51 | -- | -- | 2009 |
| Wyoming | $69.63* | -- | -- | 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
- A2001 - Innovamatrix ac, per square centimeter (add-on, list separately in addition to primary procedure)
- 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 E0657?
22 state Medicaid programs publish a fee-for-service rate for E0657 (segmental pneumatic appliance for use with pneumatic compressor, chest), ranging from $36.66 in New Hampshire to $773.70 in Minnesota. The full table on this page lists every publishing state's current rate.
Which state pays the most for E0657?
Minnesota publishes the highest Medicaid rate for E0657 at $773.70. New Hampshire publishes the lowest at $36.66.
Does E0657 require prior authorization under Medicaid?
4 of the 22 publishing states flag E0657 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".