Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for K0859. 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
40
Median % of Medicare
--
Rate range
$32.98 - $12,366.30
K0859 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $8,244.20 | -- | -- | 2026 |
| Arizona | $40.41* | -- | -- | 2026 |
| California | $6,711.70 | -- | -- | 2026 |
| Colorado | $7,173.49 | -- | Required | 2026 |
| Connecticut | $5,590.09 | -- | Required | 2013 |
| District of Columbia | $11,638.85 | -- | Required | 2025 |
| Florida | $5,600.44 | -- | -- | 2026 |
| Georgia | $5,369.36* | -- | -- | 2026 |
| Hawaii | $671.17 | -- | -- | 2025 |
| Iowa | $6,363.79 | -- | -- | 2024 |
| Idaho | $7,122.99* | -- | Required | 2026 |
| Illinois | $5,709.65 | -- | -- | 2026 |
| Indiana | $8,082.53* | -- | Required | 2025 |
| Kansas | $500.00 | -- | -- | 2006 |
| Kentucky | $12,366.30 | -- | -- | 2026 |
| Massachusetts | $1,183.96* | -- | -- | 2026 |
| Maryland | $10,511.36 | -- | Required | 2026 |
| Maine | $8,244.20* | -- | -- | 2026 |
| Michigan | $8,713.90 | -- | -- | 2026 |
| Minnesota | $8,244.20 | -- | Required | 2026 |
| Missouri | $6,636.17* | -- | Required | 2019 |
| Mississippi | $32.98* | -- | -- | 2026 |
| Montana | $12,366.30 | -- | Required | 2026 |
| North Dakota | $8,244.20 | -- | Required | 2026 |
| Nebraska | $8,212.88* | -- | -- | 2026 |
| New Jersey | $7,213.68 | -- | Required | 2026 |
| New Mexico | $1,212.38 | -- | -- | 2025 |
| Nevada | $9,592.80 | -- | -- | 2021 |
| New York | $6,778.82 | -- | -- | 2026 |
| Ohio | $5,060.80 | -- | -- | 2017 |
| Oklahoma | $8,244.20 | -- | -- | 2026 |
| Pennsylvania | $5,230.48* | -- | -- | 2007 |
| South Carolina | $530.27* | -- | -- | 2024 |
| Texas | $6,494.02* | -- | -- | 2020 |
| Virginia | $7,790.81 | -- | -- | 2026 |
| Vermont | $6,910.56 | -- | Required | 2026 |
| Washington | $8,244.20* | -- | -- | 2026 |
| Wisconsin | $8,244.20 | -- | -- | 2026 |
| West Virginia | $989.30 | -- | -- | 2026 |
| Wyoming | $7,419.78* | -- | 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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- 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 K0859?
40 state Medicaid programs publish a fee-for-service rate for K0859 (power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds), ranging from $32.98 in Mississippi to $12,366.30 in Kentucky. The full table on this page lists every publishing state's current rate.
Which state pays the most for K0859?
Kentucky publishes the highest Medicaid rate for K0859 at $12,366.30. Mississippi publishes the lowest at $32.98.
Does K0859 require prior authorization under Medicaid?
13 of the 40 publishing states flag K0859 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".