Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for E1701. 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
21
Median % of Medicare
82.1%
Rate range
$1.06 - $133.30
E1701 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arizona | $20.14 | 136.8% | -- | 2026 |
| Colorado | $12.09 | 82.1% | Required | 2026 |
| Connecticut | $8.05 | 54.7% | -- | 2009 |
| Hawaii | $11.45 | 77.8% | -- | 2025 |
| Iowa | $10.33 | 70.2% | -- | 2024 |
| Idaho | $13.06 | 88.7% | Not required | 2026 |
| Indiana | $14.81 | 100.6% | -- | 2026 |
| Kentucky | $10.15 | 69% | -- | 2026 |
| Massachusetts | $12.03 | 81.7% | -- | 2026 |
| Minnesota | $15.11 | 102.6% | Conditional | 2026 |
| Mississippi | $10.27* | 69.8% | -- | 2026 |
| North Dakota | $18.14 | 123.2% | Not required | 2026 |
| Nebraska | $128.98* | 876.2% | -- | 2026 |
| New Hampshire | $7.00 | 47.6% | Not required | 2026 |
| New Jersey | $10.35 | 70.3% | Required | 2026 |
| New Mexico | $14.81 | 100.6% | -- | 2025 |
| Ohio | $11.84 | 80.4% | -- | 2026 |
| Oklahoma | $15.11 | 102.6% | -- | 2026 |
| Texas | $1.06* | 7.2% | -- | 2013 |
| Vermont | $12.39 | 84.2% | -- | 2026 |
| Wyoming | $133.30* | 905.6% | -- | 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 125 codes from E1002 to E1841 or every dme & supplies code by number.
Frequently asked questions
How much does Medicaid pay for E1701?
21 state Medicaid programs publish a fee-for-service rate for E1701 (replacement cushions for jaw motion rehabilitation system, pkg. of 6), ranging from $1.06 in Texas to $133.30 in Wyoming, with a median of 82.1% of the national Medicare amount. The full table on this page lists every publishing state's current rate.
Which state pays the most for E1701?
Wyoming publishes the highest Medicaid rate for E1701 at $133.30 (905.6% of the national Medicare amount). Texas publishes the lowest at $1.06.
Does E1701 require prior authorization under Medicaid?
3 of the 21 publishing states flag E1701 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".