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L1980 Medicaid reimbursement rates by state

Ankle foot orthosis, single upright free plantar.... 31 state Medicaid programs publish a fee-for-service rate for L1980 at the nurse midwife level. Rates run from $100.00 in Connecticut to $496.21 in Minnesota, with a median of $308.61.

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

States publishing
31
Median rate
$308.61units vary by state
Highest
$496.21Minnesota
Medicare (non-facility)
—not on the physician fee schedule

L1980 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)$496.21since 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)$486.48since 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)$478.53since 2026-07-01——Plans negotiate; applies out of network—Rates for Prostheses, Prosthetic Devices
ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$471.11since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$413.12since 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$405.38since 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)$401.69since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$392.33since 2025-01-01——Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2025-01-
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$379.56since 2026-01-01Each—Plans must pay at least this—DMAS procedure fee file hcpcmedical.csv
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$374.25since 2026-07-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$367.20since 2026-01-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$358.47since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$340.72since 2024-07-01——Not classified—SCDHHS Durable Medical Equipment (DME) F
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$340.62since 2025-06-04——Not classified—Arkansas Medicaid Prosthetics (includes
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$331.37since 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)$308.61since 2026-01-01——Plans must pay at least this—SoonerCare Durable Medical Equipment Rat
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$283.32since 2019-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Durable Medic
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$273.78——Plans negotiate; applies out of network—NC Medicaid fee schedule 'Orthotics and
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$272.12since 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)$268.19since 2024-07-01——State sets the plan rate—Iowa Medicaid fee schedule #08 PHARMACY
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$263.51since 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)$257.98since 2010-01-01Each—Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$252.50since 2022-06-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$239.32since 2012-07-01——Plans must pay at least this—Louisiana Medicaid Durable Medical Equip
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$235.66since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$233.80since 1992-04-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Ortho
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$230.93since 2008-07-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Durable
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$230.52since 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)$221.02since 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)$130.10since 2026-07-01——Plans negotiate; applies out of network—Durable Medical Equipment and Medical Su
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 L1980?

It depends on the state. Of the 31 states with a published fee-for-service rate, the median is $308.61. Minnesota pays the most ($496.21) and Connecticut the least ($100.00).

Which state pays the highest Medicaid rate for L1980?

Minnesota, at $496.21, effective 2026-01-01.

Do managed-care plans pay the same rate for L1980?

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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