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L6885 Medicaid reimbursement rates by state

Replacement socket, shoulder disarticulation/interscapular.... 37 state Medicaid programs publish a fee-for-service rate for L6885 at the physician psychologist level. Rates run from $1,331.63 in Iowa to $7,316.03 in Hawaii, with a median of $3,268.65.

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

States publishing
37
Median rate
$3,268.65units vary by state
Highest
$7,316.03Hawaii
Medicare (non-facility)
—not on the physician fee schedule

L6885 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
HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service$7,316.03since 2026-06-01——Plans negotiate; applies out of network—Medicaid Fee-For-Service (FFS) Fee Sched
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$5,199.26since 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)$5,097.31since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$4,492.16since 2026-07-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$4,355.99since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$4,077.85since 2026-01-01——Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$4,033.17since 2017-01-01——Plans negotiate; applies out of network—Provider Type 33, Durable Medical Equipm
DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP)$3,936.67since 2026-01-01——Plans negotiate; applies out of network—DMAP 2026 DME Fee Schedule
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$3,907.64since 2021-07-01——Plans negotiate; applies out of network—HCA Prosthetics and orthotics fee schedu
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$3,899.44since 2026-01-01——Not classified—MaineCare Section 60, Medical Supplies a
MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service)$3,899.44since 2026-01-01——Not classified—Montana Healthcare Programs fee schedule
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$3,847.45since 2026-01-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$3,822.98since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$3,484.18since 2024-07-01——Not classified—SCDHHS Durable Medical Equipment (DME) F
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$3,450.07since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$3,420.45since 2026-07-01——Plans negotiate; applies out of network—Rates for Prostheses, Prosthetic Devices
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$3,360.04since 2024-07-01——Not classified—2026 Fee Schedule - Covered Procedures R
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$3,346.17since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$3,268.65since 2026-01-01——Not classified—Vermont Medicaid Fee Schedule - DME Code
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$3,149.34since 2026-04-01——Plans must pay at least this—BMS DME 2026 Rural Fee Schedule Effectiv
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$3,146.72since 2026-07-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$3,012.79since 2025-06-04——Not classified—Arkansas Medicaid Prosthetics (includes
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$3,009.70since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$2,967.04since 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)$2,873.00since 2010-07-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Prost
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$2,843.44since 2019-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Durable Medic
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$2,799.56——Plans negotiate; applies out of network—NC Medicaid fee schedule 'Orthotics and
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$2,790.63since 2026-07-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$2,763.55since 2022-06-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$2,729.61since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$2,729.61since 2026-01-01——Plans must pay at least this—SoonerCare Durable Medical Equipment Rat
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$2,724.70since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service)$2,512.85since 2012-07-01——Plans negotiate; applies out of network—RI Medicaid Interactive Fee For Service
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$2,357.23since 2016-07-01——Plans negotiate; applies out of network—Orthotic and Prosthetic Fee Schedule - E
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$2,319.95since 2013-03-01——Not classified—CMAP fee schedule: 10/01/2026 MEDS - Pro
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$2,116.88since 2012-07-01——Plans must pay at least this—Louisiana Medicaid Durable Medical Equip
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$1,331.63since 2018-09-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN

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 L6885?

It depends on the state. Of the 37 states with a published fee-for-service rate, the median is $3,268.65. Hawaii pays the most ($7,316.03) and Iowa the least ($1,331.63).

Which state pays the highest Medicaid rate for L6885?

Hawaii, at $7,316.03, effective 2026-06-01.

Do managed-care plans pay the same rate for L6885?

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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