Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for K0864. 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
$58.78 - $22,044.20
K0864 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $10,289.47 | -- | -- | 2026 |
| Arizona | $97.97* | -- | -- | 2026 |
| California | $1,196.45 | -- | -- | 2026 |
| Colorado | $14,144.43 | -- | Required | 2026 |
| Connecticut | $10,229.70 | -- | Required | 2013 |
| District of Columbia | $20,747.52 | -- | Required | 2025 |
| Florida | $8,389.49 | -- | -- | 2026 |
| Georgia | $9,571.60* | -- | -- | 2026 |
| Hawaii | $1,196.45 | -- | -- | 2025 |
| Iowa | $12,232.44 | -- | -- | 2024 |
| Idaho | $12,697.46* | -- | Required | 2026 |
| Illinois | $10,178.23 | -- | -- | 2026 |
| Indiana | $14,408.00* | -- | Required | 2026 |
| Kansas | $1,763.54* | -- | -- | 2026 |
| Kentucky | $10,424.97 | -- | -- | 2026 |
| Massachusetts | $2,110.55* | -- | -- | 2026 |
| Maryland | $18,737.57 | -- | Required | 2026 |
| Maine | $14,696.13* | -- | -- | 2026 |
| Michigan | $15,533.60 | -- | -- | 2026 |
| Minnesota | $14,696.13 | -- | Required | 2026 |
| Missouri | $12,143.97* | -- | Required | 2019 |
| Mississippi | $58.78* | -- | -- | 2026 |
| Montana | $22,044.20 | -- | Required | 2026 |
| North Dakota | $14,696.13 | -- | Required | 2026 |
| Nebraska | $14,640.55* | -- | -- | 2026 |
| New Jersey | $12,859.12 | -- | Required | 2026 |
| New Mexico | $2,161.20 | -- | -- | 2025 |
| Nevada | $17,100.30 | -- | -- | 2021 |
| New York | $12,084.15 | -- | -- | 2026 |
| Ohio | $9,021.50 | -- | -- | 2017 |
| Oklahoma | $14,696.13 | -- | -- | 2026 |
| Pennsylvania | $10,054.00* | -- | -- | 2007 |
| South Carolina | $850.74* | -- | -- | 2024 |
| Texas | $11,667.78* | -- | -- | 2012 |
| Utah | $10,517.27* | -- | Required | 2026 |
| Virginia | $13,887.84 | -- | -- | 2026 |
| Vermont | $12,318.84 | -- | Required | 2026 |
| Wisconsin | $14,696.13 | -- | -- | 2026 |
| West Virginia | $1,763.54 | -- | -- | 2026 |
| Wyoming | $13,226.52* | -- | 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 K0864?
40 state Medicaid programs publish a fee-for-service rate for K0864 (power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more), ranging from $58.78 in Mississippi to $22,044.20 in Montana. The full table on this page lists every publishing state's current rate.
Which state pays the most for K0864?
Montana publishes the highest Medicaid rate for K0864 at $22,044.20. Mississippi publishes the lowest at $58.78.
Does K0864 require prior authorization under Medicaid?
14 of the 40 publishing states flag K0864 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".