Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for K0861. 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
--
Rate range
$27.91 - $10,467.80
K0861 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $6,978.53 | -- | -- | 2026 |
| Arizona | $34.21* | -- | -- | 2026 |
| California | $6,817.68 | -- | -- | 2026 |
| Colorado | $6,072.14 | -- | Required | 2026 |
| Connecticut | $4,857.64 | -- | Required | 2013 |
| District of Columbia | $9,852.00 | -- | Required | 2025 |
| Florida | $6,106.68 | -- | -- | 2026 |
| Georgia | $5,681.40* | -- | -- | 2026 |
| Hawaii | $568.14 | -- | -- | 2025 |
| Iowa | $5,529.93 | -- | -- | 2024 |
| Idaho | $6,029.45* | -- | Required | 2026 |
| Illinois | $4,833.20 | -- | -- | 2026 |
| Indiana | $6,841.67* | -- | Required | 2025 |
| Kansas | $500.00 | -- | -- | 2006 |
| Kentucky | $10,467.80 | -- | -- | 2026 |
| Massachusetts | $1,002.20* | -- | -- | 2026 |
| Maryland | $8,897.63 | -- | Required | 2026 |
| Maine | $6,978.53* | -- | -- | 2026 |
| Michigan | $7,376.20 | -- | -- | 2026 |
| Minnesota | $6,978.53 | -- | Required | 2026 |
| Missouri | $5,766.62* | -- | Required | 2019 |
| Mississippi | $27.91* | -- | -- | 2026 |
| Montana | $10,467.80 | -- | Required | 2026 |
| North Dakota | $635.38 | -- | Required | 2026 |
| Nebraska | $6,143.01* | -- | -- | 2026 |
| New Hampshire | $6,377.77 | -- | Required | 2026 |
| New Jersey | $6,106.22 | -- | Required | 2026 |
| New Mexico | $1,503.30 | -- | -- | 2025 |
| Nevada | $8,121.00 | -- | -- | 2021 |
| New York | $5,738.21 | -- | -- | 2026 |
| Ohio | $6,250.00 | -- | -- | 2024 |
| Oklahoma | $6,978.53 | -- | -- | 2026 |
| Pennsylvania | $4,545.12* | -- | -- | 2007 |
| South Carolina | $403.98* | -- | -- | 2024 |
| Texas | $549.70* | -- | -- | 2020 |
| Utah | $4,994.18* | -- | Required | 2026 |
| Virginia | $6,594.70 | -- | -- | 2026 |
| Vermont | $5,849.63 | -- | Required | 2026 |
| Washington | $6,978.53* | -- | -- | 2026 |
| Wisconsin | $6,978.53 | -- | -- | 2026 |
| West Virginia | $837.42 | -- | -- | 2026 |
| Wyoming | $6,280.68* | -- | 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 K0861?
42 state Medicaid programs publish a fee-for-service rate for K0861 (power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds), ranging from $27.91 in Mississippi to $10,467.80 in Kentucky. The full table on this page lists every publishing state's current rate.
Which state pays the most for K0861?
Kentucky publishes the highest Medicaid rate for K0861 at $10,467.80. Mississippi publishes the lowest at $27.91.
Does K0861 require prior authorization under Medicaid?
15 of the 42 publishing states flag K0861 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".