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L4631 Medicaid reimbursement rates by state

Ankle foot orthosis, walking boot type. 43 state Medicaid programs publish a fee-for-service rate for L4631 at the nurse midwife level. Rates run from $100.00 in Connecticut to $2,895.26 in Alaska, with a median of $1,473.51.

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

States publishing
43
Median rate
$1,473.51units vary by state
Highest
$2,895.26Alaska
Medicare (non-facility)
—not on the physician fee schedule

L4631 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)$2,895.26since 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$2,492.64since 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)$1,967.57since 2026-01-01——Not classified—MaineCare Section 60, Medical Supplies a
DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP)$1,912.64since 2026-01-01——Plans negotiate; applies out of network—DMAP 2026 DME Fee Schedule
ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$1,891.41since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$1,811.67since 2026-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$1,791.67since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$1,776.15since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$1,751.24since 2017-01-01——Plans negotiate; applies out of network—Provider Type 33, Durable Medical Equipm
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$1,725.88since 2026-07-01——Plans negotiate; applies out of network—Rates for Prostheses, Prosthetic Devices
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$1,721.38since 2026-01-01Each—Plans must pay at least this—DMAS procedure fee file hcpcmedical.csv
MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service)$1,710.05since 2026-01-01——Not classified—Montana Healthcare Programs fee schedule
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$1,695.40since 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)$1,649.29since 2026-01-01——Not classified—Vermont Medicaid Fee Schedule - DME Code
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$1,625.74since 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)$1,585.40since 2026-07-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$1,553.93since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services)$1,539.05since 2026-01-01——Not classified—South Dakota Medicaid DME fee schedule (
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$1,530.11since 2026-04-01——Plans must pay at least this—BMS DME 2026 Rural Fee Schedule Effectiv
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$1,512.34since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$1,475.15since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health)$1,473.51since 2024-06-01——Not classified—Wyoming Medicaid Downloadable Fee Schedu
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$1,432.41since 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)$1,411.97since 2025-06-04——Not classified—Arkansas Medicaid Prosthetics (includes
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$1,408.00since 2026-07-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$1,405.45since 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$1,379.11since 2021-07-01——Plans negotiate; applies out of network—HCA Prosthetics and orthotics fee schedu
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$1,377.40since 2012-10-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Ortho
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$1,357.20since 2016-07-01——Plans negotiate; applies out of network—Orthotic and Prosthetic Fee Schedule - E
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$1,340.64since 2026-01-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$1,333.46since 2020-01-01——State sets the plan rate—KY Medicaid DME fee schedule (2020Medica
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$1,330.06——Plans negotiate; applies out of network—NC Medicaid fee schedule 'Orthotics and
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$1,329.32since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$1,295.82since 2025-07-01——State sets the plan rate—Iowa Medicaid fee schedule #08 PHARMACY
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$1,287.85since 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)$1,278.41since 2022-06-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service)$1,267.92since 2012-07-01——Plans negotiate; applies out of network—RI Medicaid Interactive Fee For Service
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$1,223.80since 2026-07-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$1,173.49since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$1,131.92since 2026-05-20——Not classified—EPSDT Referral (DME) Fee Schedule (REF-0
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$1,066.77since 2011-01-01Each—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)$926.80since 2011-01-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Durable
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 L4631?

It depends on the state. Of the 43 states with a published fee-for-service rate, the median is $1,473.51. Alaska pays the most ($2,895.26) and Connecticut the least ($100.00).

Which state pays the highest Medicaid rate for L4631?

Alaska, at $2,895.26, effective 2026-01-01.

Do managed-care plans pay the same rate for L4631?

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.

Related Equipment & supplies codes

L0120Cervical, flexible, non-adjustable, prefabricated · 48 statesL0130Cervical, flexible, thermoplastic collar, molded to patient · 48 statesL0140Cervical, semi-rigid, adjustable (plastic collar) · 48 statesL0150Cervical, semi-rigid, adjustable molded chin cup · 48 statesL0172Cervical, collar, semi-rigid thermoplastic foam, two-piece · 48 statesL0174Cervical, collar, semi-rigid, thermoplastic foam · 48 statesL0200Cervical, multiple post collar · 48 statesL0220Thoracic, rib belt, custom fabricated · 48 statesL0450Tlso, flexible, provides trunk support · 48 statesL0472Tlso, triplanar control, hyperextension · 48 statesL0482Tlso, triplanar control · 48 statesL0484Tlso, triplanar control · 48 states
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