Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for K0816. 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
39
Median % of Medicare
--
Rate range
$11.23 - $4,984.50
K0816 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $3,498.00 | -- | -- | 2026 |
| Arizona | $11.23* | -- | -- | 2026 |
| California | $397.62 | -- | -- | 2026 |
| Colorado | $1,931.29 | -- | Required | 2026 |
| Connecticut | $1,670.60 | -- | Required | 2018 |
| District of Columbia | $327.71* | -- | Required | 2026 |
| Florida | $2,809.99 | -- | -- | 2026 |
| Georgia | $2,693.92* | -- | -- | 2026 |
| Hawaii | $336.74 | -- | -- | 2025 |
| Iowa | $3,277.62 | -- | -- | 2024 |
| Idaho | $2,871.07* | -- | Required | 2026 |
| Illinois | $2,864.65 | -- | -- | 2026 |
| Indiana | $2,207.13* | -- | Required | 2025 |
| Kansas | $500.00 | -- | -- | 2006 |
| Kentucky | $3,126.70 | -- | -- | 2026 |
| Massachusetts | $310.29* | -- | -- | 2026 |
| Maryland | $2,785.53 | -- | Required | 2026 |
| Maine | $498.45* | -- | -- | 2026 |
| Michigan | $3,495.60 | -- | -- | 2026 |
| Minnesota | $2,358.26 | -- | Required | 2026 |
| Missouri | $2,940.84* | -- | Required | 2017 |
| Mississippi | $13.29* | -- | -- | 2026 |
| Montana | $4,984.50 | -- | Required | 2026 |
| North Dakota | $2,358.27 | -- | Required | 2026 |
| Nebraska | $4,120.57* | -- | -- | 2026 |
| New Mexico | $400.87 | -- | -- | 2023 |
| Nevada | $3,749.10 | -- | -- | 2020 |
| New York | $3,401.07 | -- | -- | 2026 |
| Ohio | $2,539.14 | -- | Not required | 2017 |
| Oklahoma | $4,984.50 | -- | -- | 2026 |
| Pennsylvania | $2,693.92* | -- | -- | 2007 |
| South Carolina | $239.45* | -- | -- | 2024 |
| Texas | $3,283.99* | -- | -- | 2012 |
| Virginia | $11.61 | -- | -- | 2026 |
| Vermont | $2,917.23 | -- | Required | 2026 |
| Washington | $2,274.93* | -- | -- | 2026 |
| Wisconsin | $2,151.13 | -- | -- | 2026 |
| West Virginia | $398.76 | -- | -- | 2026 |
| Wyoming | $2,052.40* | -- | 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
- 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 107 codes from K0001 to K0864 or every dme & supplies code by number.
Frequently asked questions
How much does Medicaid pay for K0816?
39 state Medicaid programs publish a fee-for-service rate for K0816 (power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds), ranging from $11.23 in Arizona to $4,984.50 in Montana. The full table on this page lists every publishing state's current rate.
Which state pays the most for K0816?
Montana publishes the highest Medicaid rate for K0816 at $4,984.50. Arizona publishes the lowest at $11.23.
Does K0816 require prior authorization under Medicaid?
12 of the 39 publishing states flag K0816 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".