Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for E2628. 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
30
Median % of Medicare
79.3%
Rate range
$80.20 - $1,196.45
E2628 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arkansas | $801.99* | 84.3% | -- | 2026 |
| Arizona | $1,196.45 | 125.8% | -- | 2026 |
| California | $80.20 | 8.4% | -- | 2026 |
| Colorado | $718.74 | 75.6% | Required | 2026 |
| Connecticut | $647.61 | 68.1% | Required | 2013 |
| Florida | $688.43 | 72.4% | -- | 2026 |
| Iowa | $772.87 | 81.3% | -- | 2024 |
| Idaho | $906.72* | 95.3% | Not required | 2026 |
| Illinois | $753.87 | 79.3% | -- | 2026 |
| Indiana | $857.82* | 90.2% | -- | 2026 |
| Kansas | $723.57 | 76.1% | -- | 2026 |
| Louisiana | $540.62 | 56.8% | -- | 2026 |
| Maryland | $757.33 | 79.6% | -- | 2026 |
| Minnesota | $927.22 | 97.5% | Required | 2026 |
| Montana | $963.78 | 101.3% | Not required | 2026 |
| North Dakota | $692.27 | 72.8% | Required | 2026 |
| New Hampshire | $762.38 | 80.2% | Required | 2026 |
| New Jersey | $657.20 | 69.1% | Required | 2026 |
| New Mexico | $864.88 | 90.9% | -- | 2025 |
| Nevada | $825.43* | 86.8% | -- | 2018 |
| New York | $719.29 | 75.6% | -- | 2026 |
| Ohio | $633.99 | 66.7% | Not required | 2017 |
| Oklahoma | $1,049.44 | 110.3% | -- | 2026 |
| Pennsylvania | $641.59* | 67.5% | -- | 2012 |
| Texas | $714.04* | 75.1% | -- | 2017 |
| Utah | $703.02* | 73.9% | Required | 2026 |
| Virginia | $983.15 | 103.4% | -- | 2026 |
| Vermont | $891.95 | 93.8% | -- | 2026 |
| Wisconsin | $247.80 | 26.1% | -- | 2012 |
| West Virginia | $723.57 | 76.1% | -- | 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 E2628?
30 state Medicaid programs publish a fee-for-service rate for E2628 (wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining), ranging from $80.20 in California to $1,196.45 in Arizona, with a median of 79.3% of the national Medicare amount. The full table on this page lists every publishing state's current rate.
Which state pays the most for E2628?
Arizona publishes the highest Medicaid rate for E2628 at $1,196.45 (125.8% of the national Medicare amount). California publishes the lowest at $80.20.
Does E2628 require prior authorization under Medicaid?
7 of the 30 publishing states flag E2628 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".