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L5614 Medicaid reimbursement rates by state

Addition to lower extremity, exoskeletal system. 23 state Medicaid programs publish a fee-for-service rate for L5614 at the nurse midwife level. Rates run from $1,062.81 in California to $2,382.73 in Virginia, with a median of $1,507.64.

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

States publishing
23
Median rate
$1,507.64units vary by state
Highest
$2,382.73Virginia
Medicare (non-facility)
—not on the physician fee schedule

L5614 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
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$2,382.73since 1995-08-01——Plans negotiate; applies out of network—DMAS procedure fee file hcpcmedical.csv
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$2,077.88since 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)$2,037.14since 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)$1,778.94since 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)$1,775.35since 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)$1,773.43since 2023-01-01——Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2023-01-
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$1,723.85since 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)$1,699.13since 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)$1,621.33since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$1,539.04since 2010-07-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Prost
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$1,524.24since 2021-07-01——Plans negotiate; applies out of network—HCA Prosthetics and orthotics fee schedu
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$1,507.64since 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)$1,419.64since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$1,380.23since 2019-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Durable Medic
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$1,374.76since 2008-07-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Durable
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$1,356.17——Plans negotiate; applies out of network—NC Medicaid fee schedule 'Orthotics and
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$1,305.33since 2020-01-01——State sets the plan rate—KY Medicaid DME fee schedule (2020Medica
IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$1,281.24since 2024-07-01——State sets the plan rate—Iowa Medicaid fee schedule #08 PHARMACY
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$1,204.82since 2013-03-01——Not classified—CMAP fee schedule: 10/01/2026 MEDS - Pro
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$1,141.90since 2016-07-01——Plans negotiate; applies out of network—Orthotic and Prosthetic Fee Schedule - E
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$1,133.98since 2012-07-01——Plans must pay at least this—Louisiana Medicaid Durable Medical Equip
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$1,080.22since 2010-01-01Each—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)$1,062.81since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d

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 L5614?

It depends on the state. Of the 23 states with a published fee-for-service rate, the median is $1,507.64. Virginia pays the most ($2,382.73) and California the least ($1,062.81).

Which state pays the highest Medicaid rate for L5614?

Virginia, at $2,382.73, effective 1995-08-01.

Do managed-care plans pay the same rate for L5614?

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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