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L6026 Medicaid reimbursement rates by state

Transcarpal/metacarpal or partial hand disarticulation.... 19 state Medicaid programs publish a fee-for-service rate for L6026 at the nurse midwife level. Rates run from $2,681.11 in Texas to $6,519.48 in Wisconsin, with a median of $4,543.03.

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

States publishing
19
Median rate
$4,543.03units vary by state
Highest
$6,519.48Wisconsin
Medicare (non-facility)
—not on the physician fee schedule

L6026 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
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$6,519.48since 2015-01-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Durable
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$5,817.79since 2022-06-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$5,356.25since 2026-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$5,317.65since 2024-07-01——State sets the plan rate—Iowa Medicaid fee schedule #08 PHARMACY
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$5,251.23since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$4,766.41since 2022-01-01——Plans must pay at least this—NC Medicaid fee schedule 'Nurse Practiti
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$4,766.41since 2020-01-01——State sets the plan rate—KY Medicaid DME fee schedule (2020Medica
ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$4,753.51since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$4,571.46since 2023-01-01——Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2023-01-
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$4,543.03since 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)$4,461.07since 2024-01-01——Plans must pay at least this—DMAS procedure fee file hcpcmedical.csv
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$4,193.22since 2026-01-01——Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$4,001.59since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$3,813.13since 2016-07-01——Plans negotiate; applies out of network—Orthotic and Prosthetic Fee Schedule - E
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$3,621.62since 2026-05-20——Not classified—EPSDT Referral (DME) Fee Schedule (REF-0
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$3,574.81since 2015-03-01——Not classified—CMAP fee schedule: 10/01/2026 MEDS - Pro
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$3,373.24since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$3,217.33since 2015-01-01——Plans must pay at least this—Louisiana Medicaid Durable Medical Equip
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$2,681.11since 2015-01-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Ortho

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 L6026?

It depends on the state. Of the 19 states with a published fee-for-service rate, the median is $4,543.03. Wisconsin pays the most ($6,519.48) and Texas the least ($2,681.11).

Which state pays the highest Medicaid rate for L6026?

Wisconsin, at $6,519.48, effective 2015-01-01.

Do managed-care plans pay the same rate for L6026?

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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