T5001 Medicaid reimbursement rates by state
Medical supplies. 7 state Medicaid programs publish a fee-for-service rate for T5001. Rates run from $2.81 in Wisconsin to $1,408.43 in New York, with a median of $499.88.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 7
- Median rate
- $499.88units vary by state
- Highest
- $1,408.43New York
- Medicare (non-facility)
- —not on the physician fee schedule
T5001 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.
| State | Medicaid rate | Unit | Per hour | Managed-care plans | % of Medicare | Source |
|---|---|---|---|---|---|---|
| New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service) | $1,408.43since 2025-04-01 | — | — | Plans negotiate; applies out of network | — | eMedNY NYS Medicaid DMEPOS Fee Schedule |
| VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA) | $1,063.20since 2023-03-01 | — | — | Not classified | — | Vermont Medicaid Fee Schedule - DME Code |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $1,053.34since 2024-07-01 | — | — | Not classified | — | SCDHHS Durable Medical Equipment (DME) F |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $499.88since 2025-09-01 | — | — | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $396.33since 2010-07-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file hcpcmedical.csv |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $353.53since 2021-01-01 | — | — | Not classified | — | Maryland Medicaid DME/DMS/Oxygen, Prosth |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $2.81since 2016-09-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Durable |
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 T5001?
It depends on the state. Of the 7 states with a published fee-for-service rate, the median is $499.88. New York pays the most ($1,408.43) and Wisconsin the least ($2.81).
Which state pays the highest Medicaid rate for T5001?
New York, at $1,408.43, effective 2025-04-01.
Do managed-care plans pay the same rate for T5001?
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.