L5976 Medicaid reimbursement rates by state
All lower extremity prostheses, energy storing foot. 31 state Medicaid programs publish a fee-for-service rate for L5976 at the nurse midwife level. Rates run from $312.24 in Florida to $765.88 in Arizona, with a median of $515.11.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 31
- Median rate
- $515.11units vary by state
- Highest
- $765.88Arizona
- Medicare (non-facility)
- —not on the physician fee schedule
L5976 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.
| State | Medicaid rate | Unit | Per hour | Managed-care plans | % of Medicare | Source |
|---|---|---|---|---|---|---|
| ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $765.88since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Durable |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $737.86since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Rates for Prostheses, Prosthetic Devices |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $723.64since 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) | $709.45since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $663.09since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $617.82since 2026-07-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $605.58since 2026-07-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $587.02since 2024-10-01 | — | — | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $582.77since 2026-01-01 | — | — | Not classified | — | Maryland Medicaid DME/DMS/Oxygen, Prosth |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $576.03since 2021-07-01 | — | — | Plans negotiate; applies out of network | — | HCA Prosthetics and orthotics fee schedu |
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service) | $574.16since 2025-06-04 | — | — | Not classified | — | Arkansas Medicaid Prosthetics (includes |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $572.15since 2025-01-01 | — | — | Plans negotiate; applies out of network | — | HFS DME Fee Schedule (effective 2025-01- |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $553.91since 2024-07-01 | — | — | Not classified | — | SCDHHS Durable Medical Equipment (DME) F |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $535.49since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Medical Suppliers/Orthotists/Prost |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $520.20since 2026-01-01 | — | — | Plans must pay at least this | — | SoonerCare Durable Medical Equipment Rat |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $515.11since 2019-07-01 | — | — | Plans negotiate; applies out of network | — | MO HealthNet fee schedule: Durable Medic |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $507.97since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Child Health Plan Plus FY 2026-2027 Fee |
| IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $496.72since 2025-07-01 | — | — | State sets the plan rate | — | Iowa Medicaid fee schedule #08 PHARMACY |
| New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service) | $479.75since 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) | $478.77since 2008-07-01 | — | — | 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) | $464.09since 2013-03-01 | — | — | Not classified | — | CMAP fee schedule: 10/01/2026 MEDS - Pro |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $445.07 | — | — | 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) | $428.39since 2020-01-01 | — | — | State sets the plan rate | — | KY Medicaid DME fee schedule (2020Medica |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $403.42since 2012-07-01 | — | — | Plans must pay at least this | — | Louisiana Medicaid Durable Medical Equip |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $400.00since 1990-01-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file hcpcmedical.csv |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $376.20since 2010-01-01 | Each | — | Plans negotiate; applies out of network | — | ODM DMEPOS combined payment schedules (a |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $374.74since 2016-07-01 | — | — | Plans negotiate; applies out of network | — | Orthotic and Prosthetic Fee Schedule - E |
| TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP) | $364.29since 2026-03-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Prost |
| AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules) | $359.30since 2026-05-20 | — | — | Not classified | — | EPSDT Referral (DME) Fee Schedule (REF-0 |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $332.32since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $312.24since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Durable Medical Equipment and Medical Su |
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 L5976?
It depends on the state. Of the 31 states with a published fee-for-service rate, the median is $515.11. Arizona pays the most ($765.88) and Florida the least ($312.24).
Which state pays the highest Medicaid rate for L5976?
Arizona, at $765.88, effective 2026-10-01.
Do managed-care plans pay the same rate for L5976?
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
A7000Canister, disposable, used with suction pump, each · 32 statesA8001Helmet, protective, hard, prefabricated · 32 statesB9002Enteral nutrition infusion pump, any type · 32 statesE0105Cane, quad or three prong, includes canes of all materials · 32 statesE0130Walker, rigid (pickup), adjustable or fixed height · 32 statesE0135Walker, folding (pickup), adjustable or fixed height · 32 statesE0143Walker, folding, wheeled, adjustable or fixed height · 32 statesE0149Walker, heavy duty, wheeled, rigid or folding, any type · 32 statesE0155Wheel attachment, rigid pick-up walker, per pair · 32 statesE0163Commode chair, mobile or stationary, with fixed arms · 32 statesE0184Dry pressure mattress · 32 statesE0185Gel or gel-like pressure pad for mattress · 32 states
Track L5976 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.