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Billing code E1594 · Equipment & supplies

E1594 Medicaid reimbursement rate by state (2026)

Cycler dialysis machine for peritoneal dialysis. Medicaid pays a median of $344.71 for E1594 across 11 states, from $5.00 in Hawaii to $3,494.40 in Idaho.

Data as of Oct 5, 202611 statesEvery rate links to its official source

States publishing
11
National median
$344.71units vary by state
Lowest
$5.00Hawaii
Highest
$3,494.40Idaho
Answer

What does Medicaid pay for E1594?

11 state Medicaid programs publish a fee-for-service rate for E1594. The national median is $344.71 (units differ between states). Idaho pays the most, $3,494.40, and Hawaii the least, $5.00, a 698.9x spread.

State ranking

E1594 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 11 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Idaho Source · since 2025-09-01$3,494.40——Not classified—
2Colorado Source · since 2023-01-01$643.89——Not classified—
3Texas Source · since 2026-09-01$571.95——Plans negotiate; applies out of network—
5Wisconsin Source · since 2006-10-01$397.55——Not classified—
6Louisiana Source · since 2021-09-01$344.71——Plans must pay at least this—
10Kansas Source · since 1989-01-01$70.69——Not classified—
11Hawaii Source · since 2024-03-04$5.00——Plans negotiate; applies out of network—
See all 11 states for E1594 — start free

4 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.

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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 E1594 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 E1594, 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. 3 of the 11 states list more than one rate for E1594, 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. None of the 11 schedules prints a separate unit for E1594, so each amount is a flat payment for one service as the code defines it.
  • Per hour. E1594 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 E1594, 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 E1594 rates differ between states

Published rates for E1594 run from $5.00 in Hawaii to $3,494.40 in Idaho, a 698.9x gap in the same unit. Half the states pay more than the median of $344.71 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. 2 states set the current rate for E1594 in 2026 or later, while 5 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 E1594

No managed-care plan publishes what it pays for E1594. What is public is the rule each state's plan contracts set, and that rule decides how much the published rate matters when you contract with a plan.

In 2 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 4 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 5 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (4 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.
  • The state sets the plan rate (1 state). 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 Idaho managed care.

Billing

Units and billing for E1594

E1594 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.

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. Pricing modifiers decide which amount applies: NU for a new purchase, RR for a monthly rental and UE for used equipment.

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 E1594?

It depends on the state. Of the 11 states with a published fee-for-service rate, the median is $344.71. Idaho pays the most ($3,494.40) and Hawaii the least ($5.00).

Which state pays the highest Medicaid rate for E1594?

Idaho, at $3,494.40, effective 2025-09-01.

Which state pays the lowest Medicaid rate for E1594?

Hawaii, at $5.00, effective 2024-03-04.

What unit is E1594 billed in?

None of the 11 schedules prints a separate unit for E1594, so each amount is a flat payment for one service as the code defines it.

Do managed-care plans pay the same rate for E1594?

Not necessarily. In 2 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 4 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 5 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.