E2294 Medicaid reimbursement rate by state (2026)
Seat, contoured, for pediatric size wheelchair including.... Medicaid pays a median of $223.00 for E2294 across 14 states, from $22.58 in Nevada to $1,500.00 in Connecticut.
- States publishing
- 14
- National median
- $223.00units vary by state
- Lowest
- $22.58Nevada
- Highest
- $1,500.00Connecticut
What does Medicaid pay for E2294?
14 state Medicaid programs publish a fee-for-service rate for E2294. The national median is $223.00 (units differ between states). Connecticut pays the most, $1,500.00, and Nevada the least, $22.58, a 66.4x spread.
E2294 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 14 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 E2294, 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. 8 of the 14 states list more than one rate for E2294, 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 14 states, 2 publish E2294 per unit, and 12 schedules print no unit at all (a flat amount per service).
- Per hour. E2294 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 E2294, 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 E2294 rates differ between states
Published rates for E2294 run from $22.58 in Nevada to $1,500.00 in Connecticut, a 66.4x gap in the same unit. Half the states pay more than the median of $223.00 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. 2 states set the current rate for E2294 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 E2294
What a plan pays for E2294 is negotiated privately, but the state decides how much room there is to negotiate. Here is how the rules break down across the 14 states.
In 1 state, the published rate binds plans: a floor, a pass-through or a state-set rate. In 9 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 4 states is not classified yet.
- Plans negotiate; the published rate applies out of network (9 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.
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 Connecticut managed care.
Units and billing for E2294
E2294 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 E2294?
It depends on the state. Of the 14 states with a published fee-for-service rate, the median is $223.00. Connecticut pays the most ($1,500.00) and Nevada the least ($22.58).
Which state pays the highest Medicaid rate for E2294?
Connecticut, at $1,500.00, effective 2016-11-01.
Which state pays the lowest Medicaid rate for E2294?
Nevada, at $22.58, effective 2011-08-01.
What unit is E2294 billed in?
Of the 14 states, 2 publish E2294 per unit, and 12 schedules print no unit at all (a flat amount per service).
Do managed-care plans pay the same rate for E2294?
Not necessarily. In 1 state, the published rate binds plans: a floor, a pass-through or a state-set rate. In 9 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 4 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.