L7520 Medicaid reimbursement rates by state
Repair prosthetic device, labor component, per 15 minutes. 38 state Medicaid programs publish a fee-for-service rate for L7520 at the physician psychologist level. Rates run from $7.50 in Pennsylvania to $50.77 in Montana, with a median of $23.43.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 38
- Median rate
- $23.43units vary by state
- Highest
- $50.77Montana
- Medicare (non-facility)
- —not on the physician fee schedule
L7520 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 |
|---|---|---|---|---|---|---|
| MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service) | $50.77since 2026-01-01 | 15 min | $203.08 | Not classified | — | Montana Healthcare Programs fee schedule |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $50.33since 2026-07-01 | 15 min | $201.32 | Plans negotiate; applies out of network | — | HCA Prosthetics and orthotics fee schedu |
| HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service | $49.44since 2026-06-01 | 15 min | $197.76 | Plans negotiate; applies out of network | — | Medicaid Fee-For-Service (FFS) Fee Sched |
| UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan) | $45.33since 2026-07-01 | 15 min | $181.32 | Plans negotiate; applies out of network | — | Utah Medicaid Coverage and Reimbursement |
| OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA) | $41.54since 2024-10-01 | 15 min | $166.16 | Plans negotiate; applies out of network | — | OHP FFS medical-dental fee schedule (fee |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $40.67since 2026-01-01 | 15 min | $162.68 | 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) | $40.67since 2026-01-01 | 15 min | $162.68 | Not classified | — | MaineCare Section 60, Medical Supplies a |
| DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP) | $40.67since 2026-01-01 | 15 min | $162.68 | Plans negotiate; applies out of network | — | DMAP 2026 Physician Fee Schedule |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $40.62since 2026-07-01 | 15 min | $162.48 | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $39.60since 2026-01-01 | 15 min | $158.40 | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services) | $39.60since 2026-04-01 | 15 min | $158.40 | Plans must pay at least this | — | BMS DME 2026 Rural Fee Schedule Effectiv |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $35.14since 2026-07-01 | 15 min | $140.56 | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $34.61since 2024-07-01 | 15 min | $138.44 | Not classified | — | 2026 Fee Schedule - Covered Procedures R |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $34.57since 2026-01-01 | 15 min | $138.28 | Not classified | — | Maryland Medicaid DME/DMS/Oxygen, Prosth |
| VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA) | $33.86since 2026-01-01 | 15 min | $135.44 | Not classified | — | Vermont Medicaid Fee Schedule - DME Code |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $31.88since 2026-07-01 | 15 min | $127.52 | Plans negotiate; applies out of network | — | Rates for Prostheses, Prosthetic Devices |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $30.64since 2025-01-01 | 15 min | $122.56 | Plans must pay at least this | — | New Mexico Medicaid Fee for Service HCPC |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $30.10since 2026-01-01 | 15 min | $120.40 | Plans negotiate; applies out of network | — | MDHHS Medical Suppliers/Orthotists/Prost |
| TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP) | $24.00since 2023-03-01 | 15 min | $96.00 | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Prost |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $22.85since 2021-10-01 | 15 min | $91.40 | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Durable |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $21.73 | 15 min | $86.92 | Plans negotiate; applies out of network | — | NC Medicaid fee schedule 'Orthotics and |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $19.91since 2009-05-01 | 15 min | $79.64 | Not classified | — | CMAP fee schedule: 10/01/2026 MEDS - Pro |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $19.52since 2020-08-01 | 15 min | $78.08 | Plans must pay at least this | — | SoonerCare Durable Medical Equipment Rat |
| Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service) | $18.99since 2012-07-01 | 15 min | $75.96 | 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) | $18.26since 2016-07-01 | 15 min | $73.04 | Plans negotiate; applies out of network | — | Orthotic and Prosthetic Fee Schedule - E |
| New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service) | $18.18since 2022-06-01 | 15 min | $72.72 | Plans negotiate; applies out of network | — | eMedNY NYS Medicaid DMEPOS Fee Schedule |
| IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $17.36since 2025-07-01 | 15 min | $69.44 | State sets the plan rate | — | Iowa Medicaid fee schedule #08 PHARMACY |
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $17.31since 2026-07-01 | 15 min | $69.24 | Not classified | — | Health First Colorado Physician Fee Sche |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $16.47since 2026-10-01 | 15 min | $65.88 | 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) | $16.00since 2026-05-20 | 15 min | $64.00 | Not classified | — | EPSDT Referral (DME) Fee Schedule (REF-0 |
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service) | $15.00since 2025-06-04 | 15 min | $60.00 | Not classified | — | Arkansas Medicaid Prosthetics (includes |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $12.52since 2026-07-01 | 15 min | $50.08 | Plans negotiate; applies out of network | — | Nebraska Medicaid fee schedule 471-000-5 |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $12.17since 2021-07-01 | Each | — | Plans negotiate; applies out of network | — | ODM DMEPOS payment schedule (appendix to |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $10.82since 2019-07-01 | 15 min | $43.28 | Plans negotiate; applies out of network | — | MO HealthNet fee schedule: Durable Medic |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $10.00since 2020-01-01 | 15 min | $40.00 | 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) | $10.00since 2021-09-01 | 15 min | $40.00 | Plans must pay at least this | — | Louisiana Medicaid Durable Medical Equip |
| NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $7.94since 2011-08-01 | 15 min | $31.76 | Plans negotiate; applies out of network | — | Provider Type 33, Durable Medical Equipm |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $7.50since 2005-12-12 | 15 min | $30.00 | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
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 L7520?
It depends on the state. Of the 38 states with a published fee-for-service rate, the median is $23.43. Montana pays the most ($50.77 per 15 min) and Pennsylvania the least ($7.50 per 15 min).
Which state pays the highest Medicaid rate for L7520?
Montana, at $50.77 per 15 min ($203.08 per hour), effective 2026-01-01.
Do managed-care plans pay the same rate for L7520?
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
L0120Cervical, flexible, non-adjustable, prefabricated · 45 statesL0130Cervical, flexible, thermoplastic collar, molded to patient · 45 statesL0140Cervical, semi-rigid, adjustable (plastic collar) · 45 statesL0150Cervical, semi-rigid, adjustable molded chin cup · 45 statesL0172Cervical, collar, semi-rigid thermoplastic foam, two-piece · 45 statesL0174Cervical, collar, semi-rigid, thermoplastic foam · 45 statesL0200Cervical, multiple post collar · 45 statesL0220Thoracic, rib belt, custom fabricated · 45 statesL0450Tlso, flexible, provides trunk support · 45 statesL0472Tlso, triplanar control, hyperextension · 45 statesL0482Tlso, triplanar control · 45 statesL0484Tlso, triplanar control · 45 states
Track L7520 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.