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L5703 Medicaid reimbursement rates by state

Ankle, symes, molded to patient model. 21 state Medicaid programs publish a fee-for-service rate for L5703 at the nurse midwife level. Rates run from $1,507.51 in Georgia to $3,106.52 in Minnesota, with a median of $2,137.88.

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

States publishing
21
Median rate
$2,137.88units vary by state
Highest
$3,106.52Minnesota
Medicare (non-facility)
—not on the physician fee schedule

L5703 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)$3,106.52since 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)$3,045.61since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$2,836.96since 2025-01-01——Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2025-01-
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$2,538.85since 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)$2,469.02since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$2,298.82since 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$2,254.57since 2021-07-01——Plans negotiate; applies out of network—HCA Prosthetics and orthotics fee schedu
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$2,228.23since 2024-07-01——Not classified—SCDHHS Durable Medical Equipment (DME) F
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$2,211.40since 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)$2,176.82since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$2,137.88since 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)$2,135.00since 2022-10-01Each—Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$2,018.17since 2022-06-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$2,014.95since 2008-07-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Durable
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$1,993.38since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$1,988.95since 2006-01-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Prost
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$1,930.19since 2012-01-01——Plans negotiate; applies out of network—DMAS procedure fee file hcpcmedical.csv
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$1,861.82since 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)$1,790.39——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)$1,544.40since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$1,507.51since 2016-07-01——Plans negotiate; applies out of network—Orthotic and Prosthetic Fee Schedule - E

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 L5703?

It depends on the state. Of the 21 states with a published fee-for-service rate, the median is $2,137.88. Minnesota pays the most ($3,106.52) and Georgia the least ($1,507.51).

Which state pays the highest Medicaid rate for L5703?

Minnesota, at $3,106.52, effective 2026-01-01.

Do managed-care plans pay the same rate for L5703?

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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