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L0490 Medicaid reimbursement rates by state

Tlso, sagittal-coronal control. 47 state Medicaid programs publish a fee-for-service rate for L0490 at the nurse midwife level. Rates run from $177.82 in California to $1,049.59 in Wisconsin, with a median of $266.14.

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

States publishing
47
Median rate
$266.14units vary by state
Highest
$1,049.59Wisconsin
Medicare (non-facility)
—not on the physician fee schedule

L0490 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
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$1,049.59⚠ over 3× mediansince 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)$788.18since 2026-07-01——Plans negotiate; applies out of network—Durable Medical Equipment and Medical Su
AlaskaAny qualified provider (rate does not vary by provider) · Alaska Medicaid (fee-for-service, Department of Health)$407.20since 2026-01-01——Not classified—Alaska Medicaid DMEPOS Interim Fee Sched
MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service)$351.43since 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)$347.64since 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)$342.63since 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)$340.82since 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)$339.33since 2026-01-01——Not classified—MaineCare Section 60, Medical Supplies a
DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP)$339.33since 2026-01-01——Plans negotiate; applies out of network—DMAP 2026 DME Fee Schedule
HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service$332.68since 2026-06-01——Plans negotiate; applies out of network—Medicaid Fee-For-Service (FFS) Fee Sched
South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services)$316.29since 2026-01-01——Not classified—South Dakota Medicaid DME fee schedule (
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$305.40since 2026-01-01Each—Plans must pay at least this—DMAS procedure fee file hcpcmedical.csv
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$297.01since 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)$293.18since 2026-07-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$292.39since 2024-07-01——Not classified—2026 Fee Schedule - Covered Procedures R
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$288.43since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$284.44since 2026-01-01——Not classified—Vermont Medicaid Fee Schedule - DME Code
ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$284.29since 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)$282.38since 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)$279.61since 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)$276.74since 2026-07-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$271.46since 2026-04-01——Plans must pay at least this—BMS DME 2026 Rural Fee Schedule Effectiv
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$271.23since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$266.14since 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)$263.23since 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)$259.90since 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)$259.65since 2026-07-01——Plans negotiate; applies out of network—Rates for Prostheses, Prosthetic Devices
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$257.49since 2010-07-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Ortho
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$257.25since 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)$256.88since 2022-04-20——Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2022-04-
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$255.04since 2021-07-01——Plans negotiate; applies out of network—HCA Prosthetics and orthotics fee schedu
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$252.26since 2022-06-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$251.50since 2026-07-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$244.64since 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)$237.53since 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)$233.99since 2024-07-01——State sets the plan rate—Iowa Medicaid fee schedule #08 PHARMACY
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$233.46since 2019-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Durable Medic
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$231.84since 2004-01-01——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$228.94since 2025-06-04——Not classified—Arkansas Medicaid Prosthetics (includes
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$226.90——Plans negotiate; applies out of network—NC Medicaid fee schedule 'Orthotics and
Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service)$218.66since 2012-07-01——Plans negotiate; applies out of network—RI Medicaid Interactive Fee For Service
WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health)$216.37since 2021-01-01——Not classified—Wyoming Medicaid Downloadable Fee Schedu
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$214.93since 2020-01-01——State sets the plan rate—KY Medicaid DME fee schedule (2020Medica
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$201.58since 2013-03-01——Not classified—CMAP fee schedule: 10/01/2026 MEDS - Pro
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$191.05since 2016-07-01——Plans negotiate; applies out of network—Orthotic and Prosthetic Fee Schedule - E
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$183.17since 2026-05-20——Not classified—EPSDT Referral (DME) Fee Schedule (REF-0
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$177.82since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d

Rates marked ⚠ are more than three times the median for the same unit; they are published as shown but often reflect an office (non-facility) fee or a different scope of service. 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 L0490?

It depends on the state. Of the 47 states with a published fee-for-service rate, the median is $266.14. Wisconsin pays the most ($1,049.59) and California the least ($177.82).

Which state pays the highest Medicaid rate for L0490?

Wisconsin, at $1,049.59, effective 2008-07-01.

Do managed-care plans pay the same rate for L0490?

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.

Related Equipment & supplies codes

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