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L3973 Medicaid reimbursement rates by state

Shoulder elbow wrist hand orthosis, abduction positioning. 18 state Medicaid programs publish a fee-for-service rate for L3973 at the nurse midwife level. Rates run from $1,093.39 in Texas to $2,218.63 in Minnesota, with a median of $1,662.95.

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

States publishing
18
Median rate
$1,662.95units vary by state
Highest
$2,218.63Minnesota
Medicare (non-facility)
—not on the physician fee schedule

L3973 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)$2,218.63since 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)$2,175.13since 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)$1,948.91since 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)$1,899.46since 2026-07-01——Plans negotiate; applies out of network—Rates for Prostheses, Prosthetic Devices
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$1,895.64since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$1,840.64since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$1,814.25since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$1,708.61since 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)$1,698.40since 2026-01-01Each—Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$1,627.50since 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)$1,595.98since 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)$1,534.67since 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)$1,515.82since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$1,448.04——Plans negotiate; applies out of network—NC Medicaid fee schedule 'Orthotics and
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$1,433.96since 2020-01-01——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)$1,219.26since 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)$1,134.82since 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)$1,093.39since 2026-03-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Ortho

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 L3973?

It depends on the state. Of the 18 states with a published fee-for-service rate, the median is $1,662.95. Minnesota pays the most ($2,218.63) and Texas the least ($1,093.39).

Which state pays the highest Medicaid rate for L3973?

Minnesota, at $2,218.63, effective 2026-01-01.

Do managed-care plans pay the same rate for L3973?

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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