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L3674 Medicaid reimbursement rates by state

Shoulder orthosis, abduction positioning (airplane design). 25 state Medicaid programs publish a fee-for-service rate for L3674 at the physician psychologist level. Rates run from $754.50 in Wisconsin to $1,908.78 in New Mexico, with a median of $978.32.

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

States publishing
25
Median rate
$978.32units vary by state
Highest
$1,908.78New Mexico
Medicare (non-facility)
—not on the physician fee schedule

L3674 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
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$1,908.78since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$1,322.06since 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)$1,296.14since 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)$1,161.33since 2026-01-01Each—Plans must pay at least this—DMAS procedure fee file hcpcmedical.csv
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$1,131.86since 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)$1,081.09since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$1,063.38since 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)$1,052.48since 2026-07-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$1,038.02since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$1,026.90since 2025-06-04——Not classified—Arkansas Medicaid Prosthetics (includes
NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$1,000.97since 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)$988.34since 2024-10-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$978.32since 2026-01-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$969.82since 2021-07-01——Plans negotiate; applies out of network—HCA Prosthetics and orthotics fee schedu
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$962.68since 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)$958.79——Plans negotiate; applies out of network—NC Medicaid fee schedule 'Orthotics and
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$930.38since 2026-01-01——Plans must pay at least this—SoonerCare Durable Medical Equipment Rat
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$929.10since 2018-09-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$905.89since 2022-06-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$903.26since 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)$844.05since 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)$778.74since 2011-01-01Each—Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$759.82since 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)$758.81since 2011-01-01——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)$754.50since 2011-01-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Durable

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 L3674?

It depends on the state. Of the 25 states with a published fee-for-service rate, the median is $978.32. New Mexico pays the most ($1,908.78) and Wisconsin the least ($754.50).

Which state pays the highest Medicaid rate for L3674?

New Mexico, at $1,908.78, effective 2025-01-01.

Do managed-care plans pay the same rate for L3674?

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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