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Billing code E0658 · Equipment & supplies

E0658 Medicaid reimbursement rate by state (2026)

Segmental pneumatic appliance for use with pneumatic.... Medicaid pays a median of $150.80 for E0658 across 21 states, from $4.57 in Virginia to $1,522.80 in Minnesota.

Data as of Oct 5, 202621 statesEvery rate links to its official source

States publishing
21
National median
$150.80units vary by state
Lowest
$4.57Virginia
Highest
$1,522.80Minnesota
Answer

What does Medicaid pay for E0658?

21 state Medicaid programs publish a fee-for-service rate for E0658. The national median is $150.80 (units differ between states). Minnesota pays the most, $1,522.80, and Virginia the least, $4.57 per Each, a 333.2x spread.

State ranking

E0658 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 21 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Minnesota Source · since 2026-01-01$1,522.80——Plans negotiate; applies out of network—
2Ohio Source · since 2025-10-01$1,440.66——Plans negotiate; applies out of network—
3Vermont Source · since 2026-01-01$1,340.27——Not classified—
10Montana Source · since 2026-01-01$152.28——Not classified—
11Washington Source · since 2025-10-01$150.80——Plans negotiate; applies out of network—
12Indiana Source · since 2025-10-01$149.29unit—Plans must pay at least this—
20Arizona Source · since 2026-10-01$6.92day—Plans negotiate; applies out of network—
21Virginia Source · since 2026-01-01$4.57Each—Plans must pay at least this—
See all 21 states for E0658 — start free

13 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
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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 E0658 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 E0658, 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. 10 of the 21 states list more than one rate for E0658, 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 21 states, 2 publish E0658 per unit and 1 per day, and 18 schedules print no unit at all (a flat amount per service).
  • Per hour. E0658 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 E0658, 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 E0658 rates differ between states

Published rates for E0658 run from $4.57 in Virginia to $1,522.80 in Minnesota. The two publish it in different units (no unit printed versus Each), so part of that gap is the unit rather than the price. Half the states pay more than the median of $150.80 and half pay less. The usual reasons for a spread like this in equipment & supplies rates:

  • 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.
  • Some items are priced individually from the manufacturer's price or the supplier's invoice, so fewer states publish a fixed fee.

Timing matters too. 14 states set the current rate for E0658 in 2026 or later. 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 E0658

Most Medicaid members are in managed-care plans, and plans don't publish their provider fee schedules. For E0658, the public signal is the rule each state sets for its plans, recorded on each rate above.

In 3 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 10 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 8 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (10 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 (3 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.

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 Minnesota managed care.

Billing

Units and billing for E0658

E0658 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 E0658?

It depends on the state. Of the 21 states with a published fee-for-service rate, the median is $150.80. Minnesota pays the most ($1,522.80) and Virginia the least ($4.57 per Each).

Which state pays the highest Medicaid rate for E0658?

Minnesota, at $1,522.80, effective 2026-01-01.

Which state pays the lowest Medicaid rate for E0658?

Virginia, at $4.57 per Each, effective 2026-01-01. It publishes the code in a different unit from Minnesota, so compare per unit with care.

What unit is E0658 billed in?

Of the 21 states, 2 publish E0658 per unit and 1 per day, and 18 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for E0658?

Not necessarily. In 3 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 10 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 8 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.