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L0458 Medicaid reimbursement rates by state

Tlso, triplanar control, modular segmented spinal system. 36 state Medicaid programs publish a fee-for-service rate for L0458 at the physician psychologist level. Rates run from $404.18 in New York to $1,108.06 in Montana, with a median of $824.59.

Data as of 2026-10-05. Every rate links to the official document it came from.

States publishing
36
Median rate
$824.59units vary by state
Highest
$1,108.06Montana
Medicare (non-facility)
—not on the physician fee schedule

L0458 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.

StateMedicaid rateUnitPer hourManaged-care plans% of MedicareSource
MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service)$1,108.06since 2026-01-01——Not classified—Montana Healthcare Programs fee schedule
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$1,096.06since 2026-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$1,080.27since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$1,074.57since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$1,069.75since 2026-01-01——Not classified—MaineCare Section 60, Medical Supplies a
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$962.78since 2026-01-01Each—Plans must pay at least this—DMAS procedure fee file hcpcmedical.csv
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$946.01since 2023-01-01——State sets the plan rate—KY Medicaid DME fee schedule (2023Medica
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$936.45since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$924.27since 2026-07-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$909.29since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$896.25since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$890.29since 2024-07-01——Not classified—SCDHHS Durable Medical Equipment (DME) F
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$881.58since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$872.52since 2026-07-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$855.23since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$851.33since 2025-11-13——Not classified—Arkansas Medicaid Prosthetics (includes
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$839.01since 2026-01-01——Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$829.83since 2017-01-01——Plans negotiate; applies out of network—Provider Type 33, Durable Medical Equipm
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$819.35since 2024-10-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$818.56since 2026-07-01——Plans negotiate; applies out of network—Rates for Prostheses, Prosthetic Devices
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$811.08since 2026-01-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$809.91since 2019-11-13——Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2019-11-
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$804.00since 2021-07-01——Plans negotiate; applies out of network—HCA Prosthetics and orthotics fee schedu
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$771.32since 2026-01-01——Plans must pay at least this—SoonerCare Durable Medical Equipment Rat
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$748.83since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$737.75since 2024-07-01——State sets the plan rate—Iowa Medicaid fee schedule #08 PHARMACY
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$715.35——Plans negotiate; applies out of network—NC Medicaid fee schedule 'Orthotics and
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$700.77since 2004-01-01——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$661.15since 2003-06-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Ortho
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$651.11since 2019-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Durable Medic
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$602.33since 2016-07-01——Plans negotiate; applies out of network—Orthotic and Prosthetic Fee Schedule - E
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$596.41since 2008-07-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Durable
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$586.18since 2026-07-01——Plans negotiate; applies out of network—Durable Medical Equipment and Medical Su
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$577.50since 2026-05-27——Not classified—DME/POP Fee Schedule (REF-0132-Q)
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$560.62since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$404.18since 2022-06-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule

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 L0458?

It depends on the state. Of the 36 states with a published fee-for-service rate, the median is $824.59. Montana pays the most ($1,108.06) and New York the least ($404.18).

Which state pays the highest Medicaid rate for L0458?

Montana, at $1,108.06, effective 2026-01-01.

Do managed-care plans pay the same rate for L0458?

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.

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