E0371 Medicaid reimbursement rate by state (2026)
Nonpowered advanced pressure reducing overlay for mattress. Medicaid pays a median of $321.49 for E0371 across 37 states, from $10.62 in California to $4,644.81 in Ohio.
- States publishing
- 37
- National median
- $321.49units vary by state
- Lowest
- $10.62California
- Highest
- $4,644.81Ohio
What does Medicaid pay for E0371?
37 state Medicaid programs publish a fee-for-service rate for E0371. The national median is $321.49 (units differ between states). Ohio pays the most, $4,644.81 per Each, and California the least, $10.62, a 437.4x spread.
E0371 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 37 states with every variant, modifier and effective date.
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 E0371, 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. 28 of the 37 states list more than one rate for E0371, 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 37 states, 2 publish E0371 per unit, and 35 schedules print no unit at all (a flat amount per service).
- Per hour. E0371 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 E0371, 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.
Why E0371 rates differ between states
Published rates for E0371 run from $10.62 in California to $4,644.81 in Ohio. The two publish it in different units (Each versus no unit printed), so part of that gap is the unit rather than the price. Half the states pay more than the median of $321.49 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. 24 states set the current rate for E0371 in 2026 or later, while 7 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.
What managed-care plans pay for E0371
What a plan pays for E0371 is negotiated privately, but the state decides how much room there is to negotiate. Here is how the rules break down across the 37 states.
In 9 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 17 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 11 states is not classified yet.
- Plans negotiate; the published rate applies out of network (17 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 (7 states). 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.
- The state sets the plan rate (2 states). There is little to negotiate on price. Contracting is about network participation, authorization and billing terms.
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 Ohio managed care.
Units and billing for E0371
E0371 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.
Frequently asked questions
What does Medicaid pay for E0371?
It depends on the state. Of the 37 states with a published fee-for-service rate, the median is $321.49. Ohio pays the most ($4,644.81 per Each) and California the least ($10.62).
Which state pays the highest Medicaid rate for E0371?
Ohio, at $4,644.81 per Each, effective 2006-04-01.
Which state pays the lowest Medicaid rate for E0371?
California, at $10.62, effective 2026-10-01. It publishes the code in a different unit from Ohio, so compare per unit with care.
What unit is E0371 billed in?
Of the 37 states, 2 publish E0371 per unit, and 35 schedules print no unit at all (a flat amount per service).
Do managed-care plans pay the same rate for E0371?
Not necessarily. In 9 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 17 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 11 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.