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L1685 Medicaid reimbursement rates by state

Hip orthosis, abduction control of hip joint. 48 state Medicaid programs publish a fee-for-service rate for L1685 at the nurse midwife level. Rates run from $100.00 in Connecticut to $3,075.46 in Alaska, with a median of $1,087.11.

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

States publishing
48
Median rate
$1,087.11units vary by state
Highest
$3,075.46Alaska
Medicare (non-facility)
—not on the physician fee schedule

L1685 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
AlaskaAny qualified provider (rate does not vary by provider) · Alaska Medicaid (fee-for-service, Department of Health)$3,075.46since 2026-01-01——Not classified—Alaska Medicaid DMEPOS Interim Fee Sched
HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service$2,686.79since 2026-06-01——Plans negotiate; applies out of network—Medicaid Fee-For-Service (FFS) Fee Sched
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$1,822.48since 2026-01-01——Not classified—MaineCare Section 60, Medical Supplies a
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$1,598.62since 2026-07-01——Plans negotiate; applies out of network—Rates for Prostheses, Prosthetic Devices
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$1,570.38since 2024-07-01——Not classified—2026 Fee Schedule - Covered Procedures R
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$1,527.67since 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)$1,526.90since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP)$1,428.89since 2026-01-01——Plans negotiate; applies out of network—DMAP 2026 Physician Fee Schedule
NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$1,413.74since 2017-01-01——Plans negotiate; applies out of network—Provider Type 33, Durable Medical Equipm
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$1,378.29since 2024-07-01——Not classified—SCDHHS Durable Medical Equipment (DME) F
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$1,366.86since 2026-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service)$1,366.86since 2026-01-01——Not classified—Montana Healthcare Programs fee schedule
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$1,364.79since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$1,340.06since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$1,340.06since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$1,286.00since 2026-01-01Each—Plans must pay at least this—DMAS procedure fee file hcpcmedical.csv
South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services)$1,230.17since 2026-01-01——Not classified—South Dakota Medicaid DME fee schedule (
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$1,214.56since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$1,180.96since 2026-07-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service)$1,174.43since 2012-07-01——Plans negotiate; applies out of network—RI Medicaid Interactive Fee For Service
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$1,173.63since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$1,143.11since 2026-04-01——Plans must pay at least this—BMS DME 2026 Rural Fee Schedule Effectiv
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$1,107.45——Plans negotiate; applies out of network—NC Medicaid fee schedule 'Orthotics and
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$1,093.49since 2026-07-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$1,080.72since 2025-01-01——Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2025-01-
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$1,065.95since 2020-01-01——State sets the plan rate—KY Medicaid DME fee schedule (2020Medica
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$1,046.93since 2024-10-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$1,027.30since 2021-07-01——Plans negotiate; applies out of network—HCA Prosthetics and orthotics fee schedu
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$1,011.48since 2026-01-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$978.19since 2026-07-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$956.80since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$956.80since 2026-01-01——Plans must pay at least this—SoonerCare Durable Medical Equipment Rat
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$955.08since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health)$935.13since 2021-01-01——Not classified—Wyoming Medicaid Downloadable Fee Schedu
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$932.48since 2016-07-01——Plans negotiate; applies out of network—Orthotic and Prosthetic Fee Schedule - E
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$895.39since 2025-06-04——Not classified—Arkansas Medicaid Prosthetics (includes
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$894.04since 2026-05-20——Not classified—EPSDT Referral (DME) Fee Schedule (REF-0
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$879.48since 2026-07-01——Plans negotiate; applies out of network—Durable Medical Equipment and Medical Su
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$875.69since 2019-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Durable Medic
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$858.50since 2022-06-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$821.36since 2024-07-01——State sets the plan rate—Iowa Medicaid fee schedule #08 PHARMACY
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$798.83since 1992-04-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Ortho
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$762.75since 2012-12-10——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$742.02since 2012-07-01——Plans must pay at least this—Louisiana Medicaid Durable Medical Equip
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$710.59since 2010-01-01Each—Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$695.91since 2008-07-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Durable
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$583.52since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$100.00since 2017-03-01——Not classified—CMAP fee schedule: 10/01/2026 MEDS - Pro

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 L1685?

It depends on the state. Of the 48 states with a published fee-for-service rate, the median is $1,087.11. Alaska pays the most ($3,075.46) and Connecticut the least ($100.00).

Which state pays the highest Medicaid rate for L1685?

Alaska, at $3,075.46, effective 2026-01-01.

Do managed-care plans pay the same rate for L1685?

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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