Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for K0856. 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
41
Median % of Medicare
--
Rate range
$27.87 - $10,450.90
K0856 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $6,967.27 | -- | -- | 2026 |
| Arizona | $34.15* | -- | -- | 2026 |
| California | $6,806.76 | -- | -- | 2026 |
| Colorado | $6,062.46 | -- | Required | 2026 |
| Connecticut | $4,849.85 | -- | Required | 2013 |
| District of Columbia | $9,836.16 | -- | Required | 2025 |
| Florida | $4,733.13 | -- | -- | 2026 |
| Georgia | $5,672.23* | -- | -- | 2026 |
| Hawaii | $567.23 | -- | -- | 2025 |
| Iowa | $5,521.07 | -- | -- | 2024 |
| Idaho | $6,019.72* | -- | Required | 2026 |
| Illinois | $4,825.40 | -- | -- | 2026 |
| Indiana | $6,830.67* | -- | Required | 2025 |
| Kansas | $500.00 | -- | -- | 2006 |
| Kentucky | $10,450.90 | -- | -- | 2026 |
| Massachusetts | $1,000.59* | -- | -- | 2026 |
| Maryland | $8,883.26 | -- | Required | 2026 |
| Maine | $6,967.27* | -- | -- | 2026 |
| Michigan | $7,364.30 | -- | -- | 2026 |
| Minnesota | $6,967.26 | -- | Required | 2026 |
| Missouri | $5,757.38* | -- | Required | 2019 |
| Mississippi | $27.87* | -- | -- | 2026 |
| Montana | $10,450.90 | -- | Required | 2026 |
| North Dakota | $634.42 | -- | Required | 2026 |
| Nebraska | $6,133.20* | -- | -- | 2026 |
| New Jersey | $6,096.36 | -- | Required | 2026 |
| New Mexico | $1,024.60 | -- | -- | 2025 |
| Nevada | $8,107.10 | -- | -- | 2021 |
| New York | $5,729.02 | -- | -- | 2026 |
| Ohio | $5,795.62 | -- | -- | 2024 |
| Oklahoma | $6,967.27 | -- | -- | 2026 |
| Pennsylvania | $4,537.84* | -- | -- | 2007 |
| South Carolina | $403.34* | -- | -- | 2024 |
| Texas | $555.89* | -- | -- | 2020 |
| Utah | $4,986.12* | -- | Required | 2026 |
| Virginia | $6,584.04 | -- | -- | 2026 |
| Vermont | $5,840.22 | -- | Required | 2026 |
| Washington | $6,967.27* | -- | -- | 2026 |
| Wisconsin | $6,967.27 | -- | -- | 2026 |
| West Virginia | $836.07 | -- | -- | 2026 |
| Wyoming | $6,270.54* | -- | 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
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- 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 K0856?
41 state Medicaid programs publish a fee-for-service rate for K0856 (power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds), ranging from $27.87 in Mississippi to $10,450.90 in Kentucky. The full table on this page lists every publishing state's current rate.
Which state pays the most for K0856?
Kentucky publishes the highest Medicaid rate for K0856 at $10,450.90. Mississippi publishes the lowest at $27.87.
Does K0856 require prior authorization under Medicaid?
14 of the 41 publishing states flag K0856 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".