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L5962 Medicaid reimbursement rates by state

Addition, endoskeletal system, below knee. 40 state Medicaid programs publish a fee-for-service rate for L5962 at the physician psychologist level. Rates run from $348.79 in California to $916.71 in Montana, with a median of $607.43.

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

States publishing
40
Median rate
$607.43units vary by state
Highest
$916.71Montana
Medicare (non-facility)
—not on the physician fee schedule

L5962 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
MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service)$916.71since 2026-01-01——Not classified—Montana Healthcare Programs fee schedule
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$828.97since 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)$823.83since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$803.84since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
NevadaPhysician or licensed psychologist (incl. BCBA-D) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$781.49since 2024-01-01——Plans must pay at least this—Provider Type 20 Physician, MD., Osteopa
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$767.57since 2026-07-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$761.44since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$734.88since 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$721.12since 2021-07-01——Plans negotiate; applies out of network—HCA Prosthetics and orthotics fee schedu
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$719.60since 2026-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$719.60since 2026-01-01——Not classified—MaineCare Section 60, Medical Supplies a
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$705.49since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$656.04since 2026-07-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$631.21since 2026-07-01——Plans negotiate; applies out of network—Rates for Prostheses, Prosthetic Devices
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$629.08since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$627.51since 2024-07-01——Not classified—SCDHHS Durable Medical Equipment (DME) F
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$621.38since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$620.06since 2024-07-01——Not classified—2026 Fee Schedule - Covered Procedures R
IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$617.12since 2025-07-01——State sets the plan rate—Iowa Medicaid fee schedule #08 PHARMACY
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$611.66since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$603.19since 2026-01-01——Not classified—Vermont Medicaid Fee Schedule - DME Code
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$600.07since 2025-06-04——Not classified—Arkansas Medicaid Prosthetics (includes
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$575.68since 2026-04-01——Plans must pay at least this—BMS DME 2026 Rural Fee Schedule Effectiv
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$572.22since 2018-10-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Prost
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$560.44since 2019-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Durable Medic
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$543.67since 2026-01-01——Plans must pay at least this—SoonerCare Durable Medical Equipment Rat
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$542.36since 2012-01-01——Plans negotiate; applies out of network—DMAS procedure fee file hcpcmedical.csv
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$532.50since 2026-01-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$531.73since 2022-04-20——Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2022-04-
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$504.21——Plans negotiate; applies out of network—NC Medicaid fee schedule 'Orthotics and
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$503.72since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$485.31since 2020-01-01——State sets the plan rate—KY Medicaid DME fee schedule (2020Medica
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$467.08since 2013-03-01——Not classified—CMAP fee schedule: 10/01/2026 MEDS - Pro
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$454.50since 2022-06-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$421.62since 2012-07-01——Plans must pay at least this—Louisiana Medicaid Durable Medical Equip
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$411.56since 2008-07-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Durable
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$407.04since 2026-05-27——Not classified—DME/POP Fee Schedule (REF-0132-Q)
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$404.33since 2026-07-01——Plans negotiate; applies out of network—Durable Medical Equipment and Medical Su
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$374.10since 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)$348.79since 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 L5962?

It depends on the state. Of the 40 states with a published fee-for-service rate, the median is $607.43. Montana pays the most ($916.71) and California the least ($348.79).

Which state pays the highest Medicaid rate for L5962?

Montana, at $916.71, effective 2026-01-01.

Do managed-care plans pay the same rate for L5962?

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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