L6038 Medicaid reimbursement rates by state
Addition to single prosthetic digit or thumb, mechanical. 5 state Medicaid programs publish a fee-for-service rate for L6038. Rates run from $11.96 in Arizona to $3,876.80 in Colorado, with a median of $295.87.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 5
- Median rate
- $295.87units vary by state
- Highest
- $3,876.80Colorado
- Medicare (non-facility)
- —not on the physician fee schedule
L6038 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 |
|---|---|---|---|---|---|---|
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $3,876.80⚠ over 3× mediansince 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Child Health Plan Plus FY 2026-2027 Fee |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $369.71since 2026-04-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $295.87since 2026-04-01 | — | — | Not classified | — | Maryland Medicaid DME/DMS/Oxygen, Prosth |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $220.68since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Durable Medical Equipment and Medical Su |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $11.96since 2026-10-01 | day | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: DME rent |
Rates marked ⚠ are more than three times the median for the same unit; they are published as shown but often reflect an office (non-facility) fee or a different scope of service. 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 L6038?
It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $295.87. Colorado pays the most ($3,876.80) and Arizona the least ($11.96 per day).
Which state pays the highest Medicaid rate for L6038?
Colorado, at $3,876.80, effective 2026-07-01.
Do managed-care plans pay the same rate for L6038?
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.