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L6935 Medicaid reimbursement rates by state

Below elbow, external power, self-suspended inner socket. 38 state Medicaid programs publish a fee-for-service rate for L6935 at the nurse midwife level. Rates run from $4,121.60 in Florida to $11,872.00 in Alaska, with a median of $8,229.51.

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

States publishing
38
Median rate
$8,229.51units vary by state
Highest
$11,872.00Alaska
Medicare (non-facility)
—not on the physician fee schedule

L6935 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
AlaskaAny qualified provider (rate does not vary by provider) · Alaska Medicaid (fee-for-service, Department of Health)$11,872.00since 2026-01-01——Not classified—Alaska Medicaid DMEPOS Interim Fee Sched
MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service)$11,203.37since 2026-01-01——Not classified—Montana Healthcare Programs fee schedule
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$10,968.08since 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)$10,753.02since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$10,598.81since 2026-01-01——Not classified—MaineCare Section 60, Medical Supplies a
DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP)$10,564.05since 2026-01-01——Plans negotiate; applies out of network—DMAP 2026 Physician Fee Schedule
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$10,387.18since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service$10,371.58since 2026-06-01——Plans negotiate; applies out of network—Medicaid Fee-For-Service (FFS) Fee Sched
South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services)$10,083.03since 2026-01-01——Not classified—South Dakota Medicaid DME fee schedule (
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$9,361.04since 2023-01-01——Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2023-01-
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$9,296.88since 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)$9,132.71since 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)$8,979.44since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$8,935.45since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$8,884.30since 2026-01-01——Not classified—Vermont Medicaid Fee Schedule - DME Code
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$8,567.54since 2026-01-01——Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$8,451.24since 2026-04-01——Plans must pay at least this—BMS DME 2026 Rural Fee Schedule Effectiv
ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$8,266.61since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$8,249.10since 2026-07-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$8,209.91since 2021-07-01——Plans negotiate; applies out of network—HCA Prosthetics and orthotics fee schedu
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$8,185.84since 2025-06-04——Not classified—Arkansas Medicaid Prosthetics (includes
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$8,116.38since 2026-01-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$8,017.68since 2026-07-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$7,962.12since 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)$7,806.03since 2010-07-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Prost
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$7,688.18since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$7,237.69since 2025-07-01——State sets the plan rate—Iowa Medicaid fee schedule #08 PHARMACY
WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health)$7,155.52since 2021-01-01——Not classified—Wyoming Medicaid Downloadable Fee Schedu
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$6,978.86since 2020-01-01——State sets the plan rate—KY Medicaid DME fee schedule (2020Medica
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$6,951.02since 2008-07-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Durable
Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service)$6,830.00since 2012-07-01——Plans negotiate; applies out of network—RI Medicaid Interactive Fee For Service
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$6,726.35since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$6,237.03since 2013-03-01——Not classified—CMAP fee schedule: 10/01/2026 MEDS - Pro
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$6,105.04since 2016-07-01——Plans negotiate; applies out of network—Orthotic and Prosthetic Fee Schedule - E
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$5,853.34since 2026-05-20——Not classified—EPSDT Referral (DME) Fee Schedule (REF-0
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$5,751.61since 2012-07-01——Plans must pay at least this—Louisiana Medicaid Durable Medical Equip
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$4,188.31since 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)$4,121.60since 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 L6935?

It depends on the state. Of the 38 states with a published fee-for-service rate, the median is $8,229.51. Alaska pays the most ($11,872.00) and Florida the least ($4,121.60).

Which state pays the highest Medicaid rate for L6935?

Alaska, at $11,872.00, effective 2026-01-01.

Do managed-care plans pay the same rate for L6935?

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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