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L6605 Medicaid reimbursement rates by state

Upper extremity additions, single pivot hinge, pair. 25 state Medicaid programs publish a fee-for-service rate for L6605 at the nurse midwife level. Rates run from $57.24 in Florida to $287.48 in Minnesota, with a median of $171.15.

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

States publishing
25
Median rate
$171.15units vary by state
Highest
$287.48Minnesota
Medicare (non-facility)
—not on the physician fee schedule

L6605 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
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$287.48since 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)$281.84since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$253.30since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$212.74since 2026-01-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$212.43since 2019-11-13——Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2019-11-
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$211.63since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$198.89since 2026-07-01——Plans negotiate; applies out of network—Rates for Prostheses, Prosthetic Devices
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$194.68since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$193.01since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$183.19since 2024-07-01——Not classified—SCDHHS Durable Medical Equipment (DME) F
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$176.75since 2022-06-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$176.43since 2021-07-01——Plans negotiate; applies out of network—HCA Prosthetics and orthotics fee schedu
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$171.15since 2012-01-01——Plans negotiate; applies out of network—DMAS procedure fee file hcpcmedical.csv
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$170.62since 1992-04-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Prost
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$164.11since 2012-07-01——Plans must pay at least this—Louisiana Medicaid Durable Medical Equip
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$149.46since 2010-01-01Pair—Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$147.19——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)$141.67since 2020-01-01——State sets the plan rate—KY Medicaid DME fee schedule (2020Medica
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$120.90since 2016-07-01——Plans negotiate; applies out of network—Orthotic and Prosthetic Fee Schedule - E
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$118.87since 1989-01-01——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$109.00since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$90.69since 2008-07-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Durable
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$87.57since 2019-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Durable Medic
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$75.29since 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)$57.24since 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 L6605?

It depends on the state. Of the 25 states with a published fee-for-service rate, the median is $171.15. Minnesota pays the most ($287.48) and Florida the least ($57.24).

Which state pays the highest Medicaid rate for L6605?

Minnesota, at $287.48, effective 2026-01-01.

Do managed-care plans pay the same rate for L6605?

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

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