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L1060 Medicaid reimbursement rates by state

Addition to ctlso or scoliosis orthosis, thoracic pad. 25 state Medicaid programs publish a fee-for-service rate for L1060 at the nurse midwife level. Rates run from $45.45 in New York to $133.10 in Minnesota, with a median of $76.93.

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

States publishing
25
Median rate
$76.93units vary by state
Highest
$133.10Minnesota
Medicare (non-facility)
—not on the physician fee schedule

L1060 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
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$133.10since 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)$130.49since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$124.49since 2026-01-01Each—Plans must pay at least this—DMAS procedure fee file hcpcmedical.csv
ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$122.76since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$117.57since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$105.94since 2025-05-01——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$100.23since 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)$98.49since 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)$98.35since 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$97.32since 2021-07-01——Plans negotiate; applies out of network—HCA Prosthetics and orthotics fee schedu
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$97.07since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$92.56since 2019-07-01——Not classified—SCDHHS Durable Medical Equipment (DME) F
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$76.93since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$75.43since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$74.38——Plans negotiate; applies out of network—NC Medicaid fee schedule 'Orthotics and
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$71.59since 2020-01-01——State sets the plan rate—KY Medicaid DME fee schedule (2020Medica
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$69.19since 2010-01-01Each—Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$64.97since 2012-07-01——Plans must pay at least this—Louisiana Medicaid Durable Medical Equip
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$64.37since 1992-04-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Ortho
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$62.63since 2016-07-01——Plans negotiate; applies out of network—Orthotic and Prosthetic Fee Schedule - E
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$57.78since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$56.67since 2019-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Durable Medic
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$54.84since 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)$48.92since 2026-07-01——Plans negotiate; applies out of network—Durable Medical Equipment and Medical Su
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$45.45since 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 L1060?

It depends on the state. Of the 25 states with a published fee-for-service rate, the median is $76.93. Minnesota pays the most ($133.10) and New York the least ($45.45).

Which state pays the highest Medicaid rate for L1060?

Minnesota, at $133.10, effective 2026-01-01.

Do managed-care plans pay the same rate for L1060?

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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