Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for E2612. 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
42
Median % of Medicare
96.7%
Rate range
$32.05 - $643.33
E2612 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $305.92 | 79.7% | -- | 2026 |
| Arkansas | $276.25* | 72% | -- | 2026 |
| Arizona | $483.55 | 126% | -- | 2026 |
| California | $369.34 | 96.2% | -- | 2026 |
| Colorado | $306.50 | 79.9% | Required | 2026 |
| Connecticut | $341.20 | 88.9% | -- | 2013 |
| District of Columbia | $519.02 | 135.2% | Required | 2026 |
| Florida | $362.71 | 94.5% | -- | 2026 |
| Georgia | $338.03* | 88.1% | -- | 2026 |
| Iowa | $406.00 | 105.8% | -- | 2024 |
| Idaho | $400.89* | 104.5% | Required | 2026 |
| Illinois | $417.05 | 108.7% | -- | 2026 |
| Indiana | $353.44* | 92.1% | Required | 2026 |
| Kansas | $346.28 | 90.2% | -- | 2026 |
| Kentucky | $309.33 | 80.6% | -- | 2026 |
| Louisiana | $261.13 | 68% | -- | 2026 |
| Massachusetts | $330.29* | 86.1% | -- | 2026 |
| Maryland | $284.87 | 74.2% | -- | 2026 |
| Maine | $519.02* | 135.2% | -- | 2026 |
| Michigan | $272.11 | 70.9% | -- | 2026 |
| Minnesota | $381.56 | 99.4% | Conditional | 2026 |
| Missouri | $388.14* | 101.1% | Varies | 2018 |
| Mississippi | $371.19* | 96.7% | -- | 2026 |
| Montana | $463.99 | 120.9% | Not required | 2026 |
| North Dakota | $643.33 | 167.6% | Required | 2026 |
| Nebraska | $356.97* | 93% | -- | 2026 |
| New Hampshire | $160.05 | 41.7% | Not required | 2026 |
| New Jersey | $242.51 | 63.2% | Required | 2026 |
| New Mexico | $394.78 | 102.9% | -- | 2025 |
| Nevada | $402.61* | 104.9% | -- | 2018 |
| New York | $385.84 | 100.5% | -- | 2026 |
| Ohio | $422.11 | 110% | Not required | 2017 |
| Oklahoma | $463.99 | 120.9% | -- | 2026 |
| Pennsylvania | $382.02* | 99.5% | -- | 2012 |
| South Carolina | $32.05* | 8.4% | -- | 2024 |
| Utah | $270.43* | 70.5% | Required | 2026 |
| Virginia | $519.02 | 135.2% | -- | 2026 |
| Vermont | $435.06 | 113.4% | -- | 2026 |
| Washington | $390.08* | 101.6% | -- | 2026 |
| Wisconsin | $341.41 | 89% | -- | 2008 |
| West Virginia | $371.19 | 96.7% | -- | 2026 |
| Wyoming | $340.09* | 88.6% | -- | 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 133 codes from E2000 to E2633 or every dme & supplies code by number.
Frequently asked questions
How much does Medicaid pay for E2612?
42 state Medicaid programs publish a fee-for-service rate for E2612 (general use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware), ranging from $32.05 in South Carolina to $643.33 in North Dakota, with a median of 96.7% of the national Medicare amount. The full table on this page lists every publishing state's current rate.
Which state pays the most for E2612?
North Dakota publishes the highest Medicaid rate for E2612 at $643.33 (167.6% of the national Medicare amount). South Carolina publishes the lowest at $32.05.
Does E2612 require prior authorization under Medicaid?
8 of the 42 publishing states flag E2612 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".