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L6624 Medicaid reimbursement rates by state

Upper extremity addition. 21 state Medicaid programs publish a fee-for-service rate for L6624 at the nurse midwife level. Rates run from $1,510.37 in Florida to $4,637.39 in Minnesota, with a median of $3,401.84.

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

States publishing
21
Median rate
$3,401.84units vary by state
Highest
$4,637.39Minnesota
Medicare (non-facility)
—not on the physician fee schedule

L6624 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)$4,637.39since 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)$4,546.46since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$3,970.28since 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)$3,962.28since 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)$3,847.33since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$3,792.15since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$3,766.86since 2024-07-01——Not classified—SCDHHS Durable Medical Equipment (DME) F
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$3,550.02since 2026-01-01——Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$3,431.67since 2026-01-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$3,411.44since 2012-01-01——Plans negotiate; applies out of network—DMAS procedure fee file hcpcmedical.csv
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$3,401.84since 2021-07-01——Plans negotiate; applies out of network—HCA Prosthetics and orthotics fee schedu
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$3,217.26since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$3,207.77since 2022-06-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$3,185.32since 2007-01-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Prost
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$3,168.39since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$3,026.71——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)$2,867.06since 2020-01-01——State sets the plan rate—KY Medicaid DME fee schedule (2020Medica
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$2,770.46since 2015-06-01——Plans must pay at least this—Louisiana Medicaid Durable Medical Equip
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$2,548.50since 2016-07-01——Plans negotiate; applies out of network—Orthotic and Prosthetic Fee Schedule - E
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$2,474.01since 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)$1,510.37since 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 L6624?

It depends on the state. Of the 21 states with a published fee-for-service rate, the median is $3,401.84. Minnesota pays the most ($4,637.39) and Florida the least ($1,510.37).

Which state pays the highest Medicaid rate for L6624?

Minnesota, at $4,637.39, effective 2026-01-01.

Do managed-care plans pay the same rate for L6624?

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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