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E1701 Medicaid reimbursement rates by state

Replacement cushions for jaw motion rehabilitation system. 21 state Medicaid programs publish a fee-for-service rate for E1701. Rates run from $1.06 in Texas to $128.98 in Nebraska, with a median of $12.03.

Data as of 2026-10-05. Every rate links to the official document it came from.

States publishing
21
Median rate
$12.03units vary by state
Highest
$128.98Nebraska
Medicare (non-facility)
—not on the physician fee schedule

E1701 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.

StateMedicaid rateUnitPer hourManaged-care plans% of MedicareSource
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$128.98⚠ over 3× mediansince 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$17.52since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service$16.02since 2026-06-01——Plans negotiate; applies out of network—Medicaid Fee-For-Service (FFS) Fee Sched
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$15.11since 2026-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$15.11since 2026-01-01——Plans must pay at least this—SoonerCare Durable Medical Equipment Rat
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$14.81since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$14.81since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP)$14.78since 2026-01-01——Plans negotiate; applies out of network—DMAP 2026 DME Fee Schedule
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$13.06since 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)$12.39since 2026-01-01——Not classified—Vermont Medicaid Fee Schedule - DME Code
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$12.03since 2026-03-01——Plans negotiate; applies out of network—Rates for Durable Medical Equipment, Oxy
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$11.84since 2026-01-01——Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$11.33since 2022-07-01——Not classified—Health First Colorado Physician Fee Sche
IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$10.33since 2024-07-01——State sets the plan rate—Iowa Medicaid fee schedule #08 PHARMACY
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$10.27since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$10.15since 2020-01-01——State sets the plan rate—KY Medicaid DME fee schedule (2020Medica
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$8.05since 2009-05-01——Not classified—CMAP fee schedule: 10/01/2026 MEDS - DME
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$7.00since 2021-01-01——Not classified—2026 Fee Schedule - Covered Procedures R
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$3.67since 2026-07-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$2.07since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$1.06since 2013-04-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Dmepo

Rates marked ⚠ are more than three times the median for the same unit; they are published as shown but often reflect an office (non-facility) fee or a different scope of service. 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 E1701?

It depends on the state. Of the 21 states with a published fee-for-service rate, the median is $12.03. Nebraska pays the most ($128.98) and Texas the least ($1.06).

Which state pays the highest Medicaid rate for E1701?

Nebraska, at $128.98, effective 2026-07-01.

Do managed-care plans pay the same rate for E1701?

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.

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