E1353 Medicaid reimbursement rates by state
Regulator. 30 state Medicaid programs publish a fee-for-service rate for E1353 at the nurse midwife level. Rates run from $0.50 in Wisconsin to $83.75 in Illinois, with a median of $32.91.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 30
- Median rate
- $32.91units vary by state
- Highest
- $83.75Illinois
- Medicare (non-facility)
- —not on the physician fee schedule
E1353 rate in every state
One like-for-like fee-for-service rate per state, highest first. Units can differ between states; the per-hour column converts time-based units.
| State | Medicaid rate | Unit | Per hour | Managed-care plans | % of Medicare | Source |
|---|---|---|---|---|---|---|
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $83.75since 2024-01-01 | — | — | Plans negotiate; applies out of network | — | HFS DME Fee Schedule (effective 2024-01- |
| ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $42.11since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Durable |
| DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP) | $40.36since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | DMAP 2026 DME Fee Schedule |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $40.36since 2026-01-01 | — | — | Plans must pay at least this | — | SoonerCare Durable Medical Equipment Rat |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $40.36since 2026-01-01 | — | — | Not classified | — | MaineCare Section 60, Medical Supplies a |
| AlaskaAny qualified provider (rate does not vary by provider) · Alaska Medicaid (fee-for-service, Department of Health) | $40.36since 2026-01-01 | — | — | Not classified | — | Alaska Medicaid DMEPOS Interim Fee Sched |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $39.57since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service | $39.57since 2026-06-01 | — | — | Plans negotiate; applies out of network | — | Medicaid Fee-For-Service (FFS) Fee Sched |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $36.32since 2026-01-01 | Each | — | Plans must pay at least this | — | DMAS procedure fee file hcpcmedical.csv |
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services) | $36.32since 2026-01-01 | — | — | Not classified | — | South Dakota Medicaid DME fee schedule ( |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $35.65since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health) | $35.61since 2026-07-01 | — | — | Not classified | — | Wyoming Medicaid Downloadable Fee Schedu |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $34.87since 2026-07-01 | — | — | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
| VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA) | $33.83since 2026-01-01 | — | — | Not classified | — | Vermont Medicaid Fee Schedule - DME Code |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $32.97since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $32.84since 2026-03-01 | — | — | Plans negotiate; applies out of network | — | Rates for Durable Medical Equipment, Oxy |
| KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $32.29since 2026-07-01 | — | — | Paid by the state, outside plans | — | KMAP Fee Schedule MKN Medicaid (FeeSched |
| District of ColumbiaAny qualified provider (rate does not vary by provider) · DC Medicaid (DHCF) fee-for-service | $32.29since 2026-04-01 | — | — | Not classified | — | REFRP00178CSV - Medical Fee Schedule Rep |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $31.65since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | ODM DMEPOS combined payment schedules (a |
| IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $31.58since 2024-07-01 | — | — | State sets the plan rate | — | Iowa Medicaid fee schedule #08 PHARMACY |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $30.91since 2024-10-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $29.67since 2022-07-01 | — | — | Not classified | — | Health First Colorado Physician Fee Sche |
| UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan) | $28.88since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Utah Medicaid Coverage and Reimbursement |
| TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP) | $27.37since 2013-04-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Dmepo |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $26.07since 2013-03-01 | — | — | Not classified | — | CMAP fee schedule: 10/01/2026 MEDS - DME |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $23.80since 2010-06-14 | — | — | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $20.00since 1999-02-01 | — | — | Not classified | — | 2026 Fee Schedule - Covered Procedures R |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $9.97since 2023-01-01 | — | — | State sets the plan rate | — | KY Medicaid DME fee schedule (2023Medica |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $5.65since 2026-07-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $0.50since 2012-09-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Durable |
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 with the CMS formula; states with several Medicare localities show a range. Confirm rates with the payer before billing.
Frequently asked questions
What does Medicaid pay for E1353?
It depends on the state. Of the 30 states with a published fee-for-service rate, the median is $32.91. Illinois pays the most ($83.75) and Wisconsin the least ($0.50).
Which state pays the highest Medicaid rate for E1353?
Illinois, at $83.75, effective 2024-01-01.
Do managed-care plans pay the same rate for E1353?
Not necessarily. Each state's plan contracts decide whether plans must pay at least the fee-for-service rate, pay a state-set rate, or negotiate their own. The table shows the rule for each state, cited to the contract or statute.
Related Equipment & supplies codes
L0120Cervical, flexible, non-adjustable, prefabricated · 50 statesL0130Cervical, flexible, thermoplastic collar, molded to patient · 50 statesL0140Cervical, semi-rigid, adjustable (plastic collar) · 50 statesL0172Cervical, collar, semi-rigid thermoplastic foam, two-piece · 50 statesL0450Tlso, flexible, provides trunk support · 50 statesL0472Tlso, triplanar control, hyperextension · 50 statesL0482Tlso, triplanar control · 50 statesL0484Tlso, triplanar control · 50 statesL0486Tlso, triplanar control · 50 statesL0627Lumbar orthosis, sagittal control · 50 statesL0700Cervical-thoracic-lumbar-sacral-orthoses (ctlso) · 50 statesL0984Protective body sock, prefabricated, off-the-shelf, each · 50 states
Track E1353 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.