S8121 Medicaid reimbursement rate by state (2026)

• Order. States are listed from the highest published rate to the lowest. No single unit is shared by 8 or more states for S8121, 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. Each state lists a single rate for S8121.
• Unit. None of the 5 schedules prints a separate unit for S8121, so each amount is a flat payment for one service as the code defines it.
• Per hour. S8121 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 S8121, 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.

Published rates for S8121 run from $0.66 in Maryland to $1.18 in Vermont, a 1.8x gap in the same unit. Half the states pay more than the median of $0.85 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. 1 state set the current rate for S8121 in 2026 or later, while 2 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 a plan pays for S8121 is negotiated privately, but the state decides how much room there is to negotiate. Here is how the rules break down across the 5 states.

In 2 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 3 states is not classified yet.

• Plans negotiate; the published rate applies out of network (2 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.

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 Vermont managed care.

S8121 is a HCPCS Level II temporary national code in the equipment & supplies line, billed mostly by durable medical equipment suppliers, orthotists, prosthetists and pharmacies. S codes were created for private payers and are widely used by Medicaid programs for services Medicare does not cover, such as home nursing and home infusion. Units range from 15 minutes to a day.

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.