L7406 Medicaid reimbursement rates by state
Addition to upper extremity prosthesis, user adjustable. 14 state Medicaid programs publish a fee-for-service rate for L7406. Rates run from $2,421.23 in Colorado to $3,168.60 in Indiana, with a median of $2,917.70.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 14
- Median rate
- $2,917.70units vary by state
- Highest
- $3,168.60Indiana
- Medicare (non-facility)
- —not on the physician fee schedule
L7406 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.
| State | Medicaid rate | Unit | Per hour | Managed-care plans | % of Medicare | Source |
|---|---|---|---|---|---|---|
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $3,168.60since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $3,150.07since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $3,150.07since 2026-06-01 | — | — | Not classified | — | MaineCare Section 60, Medical Supplies a |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $3,088.61since 2025-04-01 | — | — | Not classified | — | CMAP fee schedule: 10/01/2026 MEDS - Pro |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $3,088.30since 2025-04-01 | — | — | Plans negotiate; applies out of network | — | MO HealthNet fee schedule: Durable Medic |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $3,088.30since 2025-04-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service HCPC |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $2,932.40since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Durable |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $2,903.00since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Rates for Prostheses, Prosthetic Devices |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $2,721.66since 2026-07-01 | — | — | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $2,520.06since 2026-07-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
| MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service) | $2,520.06since 2026-07-01 | — | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, Septembe |
| New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service) | $2,470.64since 2025-10-01 | — | — | Plans negotiate; applies out of network | — | eMedNY NYS Medicaid DMEPOS Fee Schedule |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $2,470.00since 2025-04-01 | Each | — | Plans negotiate; applies out of network | — | ODM DMEPOS combined payment schedules (a |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $2,421.23since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Child Health Plan Plus FY 2026-2027 Fee |
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 L7406?
It depends on the state. Of the 14 states with a published fee-for-service rate, the median is $2,917.70. Indiana pays the most ($3,168.60 per unit) and Colorado the least ($2,421.23).
Which state pays the highest Medicaid rate for L7406?
Indiana, at $3,168.60 per unit, effective 2026-01-01.
Do managed-care plans pay the same rate for L7406?
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.