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Billing code E0203 · Equipment & supplies

E0203 Medicaid reimbursement rate by state (2026)

Therapeutic lightbox, minimum 10,000 lux, table top model. Medicaid pays a median of $79.86 for E0203 across 6 states, from $14.42 in Maine to $240.00 in Wisconsin.

Data as of Oct 5, 20266 statesEvery rate links to its official source

States publishing
6
National median
$79.86units vary by state
Lowest
$14.42Maine
Highest
$240.00Wisconsin
Answer

What does Medicaid pay for E0203?

6 state Medicaid programs publish a fee-for-service rate for E0203. The national median is $79.86 (units differ between states). Wisconsin pays the most, $240.00, and Maine the least, $14.42, a 16.6x spread.

State ranking

E0203 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 6 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Wisconsin Source · since 2019-03-01$240.00——Plans negotiate; applies out of network—
2Minnesota Source · since 2025-01-01$239.20——Plans negotiate; applies out of network—
3Indiana Source · since 2026-01-01$121.71unit—Plans must pay at least this—
6Maine Source · since 2026-01-01$14.42——Not classified—
See all 6 states for E0203 — start free

2 more states, with every modifier and provider-type variant, rate history and the plan rule in each state. 14-day free trial, no credit card.

  • Source for every rate
  • Full rate history
  • CSV and API export

Rates are per the unit shown for each state; units can differ between states. Medicare amounts are computed from the CMS relative value file and locality cost indices; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Track E0203 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
Guide

How to read this table

  • Order. States are listed from the highest published rate to the lowest. No single unit is shared by 8 or more states for E0203, so the order is by published amount and is not a like-for-like rank.
  • Medicaid rate. The most the state's fee-for-service program pays for one unit, as published. 4 of the 6 states list more than one rate for E0203, by modifier, provider type or setting; the table shows the one that matches the provider level and setting used across states, without add-ons.
  • Unit. Of the 6 states, 1 publish E0203 per unit, and 5 schedules print no unit at all (a flat amount per service).
  • Per hour. E0203 is not billed in time units in these states, so no hourly figure is shown.
  • Managed-care plans. The rule the state sets for its plans on this rate. What each rule means is explained below.
  • % of Medicare. No Medicare physician fee schedule amount is on file for E0203, so there is no percentage.
  • Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.
Context

Why E0203 rates differ between states

Published rates for E0203 run from $14.42 in Maine to $240.00 in Wisconsin, a 16.6x gap in the same unit. Half the states pay more than the median of $79.86 and half pay less. The usual reasons for a spread like this in equipment & supplies rates:

  • Some items are priced individually from the manufacturer's price or the supplier's invoice, so fewer states publish a fixed fee.
  • Many states set equipment and supply fees as a percentage of the Medicare DMEPOS fee schedule, at different percentages and from different years.
  • A single code can carry separate purchase, rental and used-equipment amounts, and states publish different subsets of them.

Timing matters too. 3 states set the current rate for E0203 in 2026 or later, while 2 states still pay a rate that took effect in 2022 or earlier. A state that has not updated its rate in years will drift down the ranking as others raise theirs.

Managed care

What managed-care plans pay for E0203

Most Medicaid members are in managed-care plans, and plans don't publish their provider fee schedules. For E0203, the public signal is the rule each state sets for its plans, recorded on each rate above.

In 1 state, the published rate binds plans: a floor, a pass-through or a state-set rate. In 2 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 3 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (2 states). In-network rates can be above or below the published rate. The published rate is the benchmark both sides know, and the fallback if no contract is signed.
  • Plans must pay at least the published rate (1 state). The published rate is your floor. Negotiate up from it, and if a plan pays less, the contract provision is the basis for a payment dispute.

Plan-negotiated rates are never estimated here. To see the rule and its citation for a particular state, open that state's managed-care page, for example Wisconsin managed care.

Billing

Units and billing for E0203

E0203 is a HCPCS Level II durable medical equipment code in the equipment & supplies line, billed mostly by durable medical equipment suppliers, orthotists, prosthetists and pharmacies. E codes cover durable medical equipment. The same code can carry a purchase price, a monthly rental and a used-equipment price, chosen with a pricing modifier.

Pricing modifiers decide which amount applies: NU for a new purchase, RR for a monthly rental and UE for used equipment. Units follow the code: per item, per pair, per box or per month of rental, so a per-unit comparison only holds when the states use the same unit.

Before billing, confirm the rate, unit and any modifier with the state's current schedule or the plan: the amounts here are as published, not a guarantee of payment.

FAQ

Frequently asked questions

What does Medicaid pay for E0203?

It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $79.86. Wisconsin pays the most ($240.00) and Maine the least ($14.42).

Which state pays the highest Medicaid rate for E0203?

Wisconsin, at $240.00, effective 2019-03-01.

Which state pays the lowest Medicaid rate for E0203?

Maine, at $14.42, effective 2026-01-01.

What unit is E0203 billed in?

Of the 6 states, 1 publish E0203 per unit, and 5 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for E0203?

Not necessarily. In 1 state, the published rate binds plans: a floor, a pass-through or a state-set rate. In 2 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 3 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.