K0839 Medicaid reimbursement rate by state (2026)
Power wheelchair, group 2 very heavy duty. Medicaid pays a median of $765.59 for K0839 across 43 states, from $1.00 in Kansas to $7,671.53 in Nebraska.
- States publishing
- 43
- National median
- $765.59units vary by state
- Lowest
- $1.00Kansas
- Highest
- $7,671.53Nebraska
What does Medicaid pay for K0839?
43 state Medicaid programs publish a fee-for-service rate for K0839. The national median is $765.59 (units differ between states). Nebraska pays the most, $7,671.53, and Kansas the least, $1.00, a 7671.5x spread.
K0839 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 43 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 K0839, 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. 32 of the 43 states list more than one rate for K0839, 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 43 states, 3 publish K0839 per unit, 1 per month and 1 per day, and 38 schedules print no unit at all (a flat amount per service).
- Per hour. K0839 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 K0839, 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 K0839 rates differ between states
Published rates for K0839 run from $1.00 in Kansas to $7,671.53 in Nebraska, a 7671.5x gap in the same unit. Half the states pay more than the median of $765.59 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. 26 states set the current rate for K0839 in 2026 or later, while 11 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 K0839
No managed-care plan publishes what it pays for K0839. 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 9 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 21 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 (21 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 (7 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.
- The state sets the plan rate (2 states). 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 Nebraska managed care.
Units and billing for K0839
K0839 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.
Frequently asked questions
What does Medicaid pay for K0839?
It depends on the state. Of the 43 states with a published fee-for-service rate, the median is $765.59. Nebraska pays the most ($7,671.53) and Kansas the least ($1.00).
Which state pays the highest Medicaid rate for K0839?
Nebraska, at $7,671.53, effective 2026-07-01.
Which state pays the lowest Medicaid rate for K0839?
Kansas, at $1.00, effective 2006-10-01.
What unit is K0839 billed in?
Of the 43 states, 3 publish K0839 per unit, 1 per month and 1 per day, and 38 schedules print no unit at all (a flat amount per service).
Do managed-care plans pay the same rate for K0839?
Not necessarily. In 9 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 21 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.