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L0470 Medicaid reimbursement rates by state

Tlso, triplanar control. 28 state Medicaid programs publish a fee-for-service rate for L0470 at the nurse midwife level. Rates run from $369.97 in Kentucky to $818.40 in Arizona, with a median of $558.51.

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

States publishing
28
Median rate
$558.51units vary by state
Highest
$818.40Arizona
Medicare (non-facility)
—not on the physician fee schedule

L0470 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
ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$818.40since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$808.59since 2026-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$792.74since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$695.52since 2026-07-01——Plans negotiate; applies out of network—Rates for Prostheses, Prosthetic Devices
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$681.07since 2024-07-01——Not classified—SCDHHS Durable Medical Equipment (DME) F
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$674.50since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$659.36since 2026-01-01Each—Plans must pay at least this—DMAS procedure fee file hcpcmedical.csv
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$622.73since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$598.36since 2026-01-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$598.25since 2024-10-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$597.93since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$597.50since 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$587.03since 2021-07-01——Plans negotiate; applies out of network—HCA Prosthetics and orthotics fee schedu
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$565.45since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$551.57since 2025-07-01——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)$547.26——Plans negotiate; applies out of network—NC Medicaid fee schedule 'Orthotics and
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$534.98since 2008-07-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Durable
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$530.15since 2019-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Durable Medic
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$511.92since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$501.49since 2013-03-01——Not classified—CMAP fee schedule: 10/01/2026 MEDS - Pro
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$479.92since 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)$479.92since 2003-05-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Ortho
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$474.04since 2026-07-01——Plans negotiate; applies out of network—Durable Medical Equipment and Medical Su
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$460.79since 2016-07-01——Plans negotiate; applies out of network—Orthotic and Prosthetic Fee Schedule - E
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$413.62since 2010-01-01Each—Plans negotiate; applies out of network—ODM DMEPOS payment schedule (appendix to
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$411.79since 2026-05-20——Not classified—EPSDT Referral (DME) Fee Schedule (REF-0
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$406.41since 2022-06-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$369.97since 2020-01-01——State sets the plan rate—KY Medicaid DME fee schedule (2020Medica

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 L0470?

It depends on the state. Of the 28 states with a published fee-for-service rate, the median is $558.51. Arizona pays the most ($818.40) and Kentucky the least ($369.97).

Which state pays the highest Medicaid rate for L0470?

Arizona, at $818.40, effective 2026-10-01.

Do managed-care plans pay the same rate for L0470?

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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