L6037 Medicaid reimbursement rates by state
Immediate post-surgical or early fitting. 5 state Medicaid programs publish a fee-for-service rate for L6037. Rates run from $1,095.75 in Colorado to $1,743.91 in Minnesota, with a median of $1,360.55.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 5
- Median rate
- $1,360.55units vary by state
- Highest
- $1,743.91Minnesota
- Medicare (non-facility)
- —not on the physician fee schedule
L6037 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 |
|---|---|---|---|---|---|---|
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $1,743.91since 2026-04-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $1,583.60since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Durable |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $1,360.55since 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) | $1,181.69since 2025-04-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Ortho |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $1,095.75since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Child Health Plan Plus FY 2026-2027 Fee |
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 L6037?
It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $1,360.55. Minnesota pays the most ($1,743.91) and Colorado the least ($1,095.75).
Which state pays the highest Medicaid rate for L6037?
Minnesota, at $1,743.91, effective 2026-04-01.
Do managed-care plans pay the same rate for L6037?
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.