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L7190 Medicaid reimbursement rates by state

Electronic elbow, adolescent, variety village or equal. 30 state Medicaid programs publish a fee-for-service rate for L7190 at the nurse midwife level. Rates run from $2,325.00 in Alabama to $12,089.57 in New Mexico, with a median of $7,648.39.

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

States publishing
30
Median rate
$7,648.39units vary by state
Highest
$12,089.57New Mexico
Medicare (non-facility)
—not on the physician fee schedule

L7190 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
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$12,089.57since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$10,332.65since 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)$10,130.05since 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)$10,117.89since 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)$9,886.43since 2026-01-01——Not classified—Montana Healthcare Programs fee schedule
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$9,085.38since 2010-07-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Prost
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$8,875.04since 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)$8,718.31since 2024-07-01——Not classified—2026 Fee Schedule - Covered Procedures R
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$8,631.95since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$8,481.17since 2026-01-01——Not classified—Vermont Medicaid Fee Schedule - DME Code
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$8,133.43since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$8,077.91since 2025-06-04——Not classified—Arkansas Medicaid Prosthetics (includes
ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$8,043.20since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$7,654.99since 2026-04-01——Plans must pay at least this—BMS DME 2026 Rural Fee Schedule Effectiv
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$7,650.61since 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)$7,646.16since 2026-01-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$7,560.21since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$7,464.61since 2026-07-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$7,331.27since 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)$7,211.93since 2012-01-01——Plans negotiate; applies out of network—DMAS procedure fee file hcpcmedical.csv
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$7,075.21since 2026-07-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$6,694.26since 2012-07-01——Plans must pay at least this—Louisiana Medicaid Durable Medical Equip
IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$6,309.61since 2024-07-01——State sets the plan rate—Iowa Medicaid fee schedule #08 PHARMACY
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$6,003.00since 2013-03-01——Not classified—CMAP fee schedule: 10/01/2026 MEDS - Pro
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$5,904.74since 2020-01-01——State sets the plan rate—KY Medicaid DME fee schedule (2020Medica
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$5,466.11since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$5,165.42since 2016-07-01——Plans negotiate; applies out of network—Orthotic and Prosthetic Fee Schedule - E
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$4,830.02since 2008-07-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Durable
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$3,543.75since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$2,325.00since 2026-05-20——Not classified—EPSDT Referral (DME) Fee Schedule (REF-0

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 L7190?

It depends on the state. Of the 30 states with a published fee-for-service rate, the median is $7,648.39. New Mexico pays the most ($12,089.57) and Alabama the least ($2,325.00).

Which state pays the highest Medicaid rate for L7190?

New Mexico, at $12,089.57, effective 2025-01-01.

Do managed-care plans pay the same rate for L7190?

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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