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L6030 Medicaid reimbursement rates by state

Upper extremity addition, external frame. 8 state Medicaid programs publish a fee-for-service rate for L6030. Rates run from $0.00 in Arkansas to $941.55 in Montana, with a median of $666.47.

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

States publishing
8
Median rate
$666.47units vary by state
Highest
$941.55Montana
Medicare (non-facility)
—not on the physician fee schedule

L6030 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)$941.55since 2026-04-01——Not classified—Montana Healthcare Programs fee schedule
AlaskaAny qualified provider (rate does not vary by provider) · Alaska Medicaid (fee-for-service, Department of Health)$874.54since 2026-04-01——Not classified—Alaska Medicaid DMEPOS Interim Fee Sched
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$714.22since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$706.16since 2026-04-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$626.77since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$600.24since 2026-04-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$519.23since 2025-04-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Ortho
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$0.00since 2025-06-04——Not classified—Arkansas Medicaid Prosthetics (includes

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 L6030?

It depends on the state. Of the 8 states with a published fee-for-service rate, the median is $666.47. Montana pays the most ($941.55) and Arkansas the least ($0.00).

Which state pays the highest Medicaid rate for L6030?

Montana, at $941.55, effective 2026-04-01.

Do managed-care plans pay the same rate for L6030?

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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