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Billing code K0601 · Equipment & supplies

K0601 Medicaid reimbursement rate by state (2026)

Replacement battery for external infusion pump owned by.... Medicaid pays a median of $1.30 for K0601 across 36 states, from $0.39 in Kansas to $1.88 in North Dakota.

Data as of Oct 5, 202636 statesEvery rate links to its official source

States publishing
36
National median
$1.30units vary by state
Lowest
$0.39Kansas
Highest
$1.88North Dakota
Answer

What does Medicaid pay for K0601?

36 state Medicaid programs publish a fee-for-service rate for K0601. The national median is $1.30 (units differ between states). North Dakota pays the most, $1.88, and Kansas the least, $0.39, a 4.8x spread.

State ranking

K0601 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 36 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1North Dakota Source · since 2026-07-01$1.88——Not classified—
2Arizona Source · since 2023-04-01$1.82——Plans negotiate; applies out of network—
3Alaska Source · since 2026-01-01$1.58——Not classified—
18Vermont Source · since 2026-01-01$1.32——Not classified—
19Massachusetts Source · since 2026-03-01$1.27——Plans negotiate; applies out of network—
20Mississippi Source · since 2026-07-01$1.26——Plans must pay at least this—
35New Hampshire Source · since 2021-01-01$0.72——Not classified—
36Kansas Source · since 2026-07-01$0.39——Not classified—
See all 36 states for K0601 — start free

28 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 K0601 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 K0601, 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 36 states list more than one rate for K0601, 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 36 states, 2 publish K0601 per unit, and 34 schedules print no unit at all (a flat amount per service).
  • Per hour. K0601 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 K0601, 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 K0601 rates differ between states

Published rates for K0601 run from $0.39 in Kansas to $1.88 in North Dakota, a 4.8x gap in the same unit. Half the states pay more than the median of $1.30 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. 21 states set the current rate for K0601 in 2026 or later, while 10 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 K0601

No managed-care plan publishes what it pays for K0601. 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 5 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 18 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 13 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (18 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 (5 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 North Dakota managed care.

Billing

Units and billing for K0601

K0601 is a HCPCS Level II temporary DME code in the equipment & supplies line, billed mostly by durable medical equipment suppliers, orthotists, prosthetists and pharmacies. K codes are temporary codes for durable equipment and supplies, priced like E codes: purchase, rental or used, by 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 K0601?

It depends on the state. Of the 36 states with a published fee-for-service rate, the median is $1.30. North Dakota pays the most ($1.88) and Kansas the least ($0.39).

Which state pays the highest Medicaid rate for K0601?

North Dakota, at $1.88, effective 2026-07-01.

Which state pays the lowest Medicaid rate for K0601?

Kansas, at $0.39, effective 2026-07-01.

What unit is K0601 billed in?

Of the 36 states, 2 publish K0601 per unit, and 34 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for K0601?

Not necessarily. In 5 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 18 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 13 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.