L3204 Medicaid reimbursement rates by state
Orthopedic shoe, hightop with supinator or pronator, infant. 32 state Medicaid programs publish a fee-for-service rate for L3204 at the physician psychologist level. Rates run from $20.07 in Michigan to $125.00 in Kansas, with a median of $41.77.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 32
- Median rate
- $41.77units vary by state
- Highest
- $125.00Kansas
- Medicare (non-facility)
- —not on the physician fee schedule
L3204 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.
| State | Medicaid rate | Unit | Per hour | Managed-care plans | % of Medicare | Source |
|---|---|---|---|---|---|---|
| KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $125.00since 2006-04-01 | — | — | Paid by the state, outside plans | — | KMAP Fee Schedule MKN Medicaid (FeeSched |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $80.73since 2025-01-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service HCPC |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $76.65since 2008-07-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Durable |
| UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan) | $70.56since 2013-11-12 | — | — | Plans negotiate; applies out of network | — | Utah Medicaid Coverage and Reimbursement |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $67.08since 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) | $57.67since 2010-01-01 | Each | — | Plans negotiate; applies out of network | — | ODM DMEPOS combined payment schedules (a |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $56.35since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Child Health Plan Plus FY 2026-2027 Fee |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $52.95since 2024-10-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA) | $50.96since 2023-03-01 | — | — | Not classified | — | Vermont Medicaid Fee Schedule - DME Code |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $50.52since 2025-01-01 | — | — | Plans negotiate; applies out of network | — | HFS DME Fee Schedule (effective 2025-01- |
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service) | $50.12since 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) | $48.00since 2025-01-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $47.39since 2018-09-01 | — | — | Plans must pay at least this | — | Iowa Medicaid fee schedule #02 PHYSICIAN |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $47.32since 2026-01-01 | — | — | Not classified | — | MaineCare Section 60, Medical Supplies a |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $44.14since 2012-07-01 | — | — | Plans must pay at least this | — | Louisiana Medicaid Durable Medical Equip |
| NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $42.20since 2011-08-01 | — | — | Plans negotiate; applies out of network | — | Provider Type 33, Durable Medical Equipm |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $41.33since 2025-09-01 | — | — | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $40.44since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $37.47since 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) | $37.09since 2019-07-01 | — | — | Plans negotiate; applies out of network | — | MO HealthNet fee schedule: Durable Medic |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $36.36since 2010-07-01 | Each | — | Plans negotiate; applies out of network | — | DMAS procedure fee file hcpcmedical.csv |
| West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services) | $36.00since 2026-04-01 | — | — | Plans must pay at least this | — | BMS DME 2026 Rural Fee Schedule Effectiv |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $35.78since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service) | $35.35since 2022-06-01 | — | — | Plans negotiate; applies out of network | — | eMedNY NYS Medicaid DMEPOS Fee Schedule |
| TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP) | $32.73since 2021-03-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Ortho |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $31.61 | — | — | Plans negotiate; applies out of network | — | NC Medicaid fee schedule 'Orthotics and |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $29.00since 2016-07-01 | — | — | Plans negotiate; applies out of network | — | Orthotic and Prosthetic Fee Schedule - E |
| ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $28.29since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Durable |
| AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules) | $27.00since 2026-05-20 | — | — | Not classified | — | EPSDT Referral (DME) Fee Schedule (REF-0 |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $25.03since 2013-03-01 | — | — | Not classified | — | CMAP fee schedule: 10/01/2026 MEDS - Pro |
| MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service) | $24.00since 1998-10-01 | — | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, June 202 |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $20.07since 2023-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Medical Suppliers/Orthotists/Prost |
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 L3204?
It depends on the state. Of the 32 states with a published fee-for-service rate, the median is $41.77. Kansas pays the most ($125.00) and Michigan the least ($20.07).
Which state pays the highest Medicaid rate for L3204?
Kansas, at $125.00, effective 2006-04-01.
Do managed-care plans pay the same rate for L3204?
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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Track L3204 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.