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L8032 Medicaid reimbursement rates by state

Nipple prosthesis, prefabricated, reusable, any type, each. 22 state Medicaid programs publish a fee-for-service rate for L8032 at the physician psychologist level. Rates run from $12.00 in Kansas to $48.75 in Montana, with a median of $38.26.

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

States publishing
22
Median rate
$38.26units vary by state
Highest
$48.75Montana
Medicare (non-facility)
—not on the physician fee schedule

L8032 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
MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service)$48.75since 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)$48.23since 2026-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$47.54since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$45.08since 2024-09-09——Plans negotiate; applies out of network—54 Pa.B. 5680 Medical Assistance Program
IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$44.27since 2024-07-01——State sets the plan rate—Iowa Medicaid fee schedule #08 PHARMACY
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$42.25since 2026-07-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$41.63since 2023-01-01——State sets the plan rate—KY Medicaid DME fee schedule (2023Medica
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$41.22since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$38.96since 2020-01-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Durable
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$38.79since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$38.35since 2026-01-01——Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$38.16since 2022-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$37.47since 2025-06-04——Not classified—Arkansas Medicaid Prosthetics (includes
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$35.69since 2026-01-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$35.49since 2012-01-01——Plans negotiate; applies out of network—DMAS procedure fee file hcpcmedical.csv
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$33.94since 2026-01-01——Plans must pay at least this—SoonerCare Durable Medical Equipment Rat
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$33.14since 2014-03-01——Not classified—CMAP fee schedule: 10/01/2026 MEDS - Pro
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$32.16since 2021-09-01——Plans must pay at least this—Louisiana Medicaid Durable Medical Equip
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$31.09since 2026-07-01——Plans negotiate; applies out of network—Rates for Prostheses, Prosthetic Devices
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$30.44since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$23.77since 2026-03-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Prost
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$12.00since 2026-07-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched

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 L8032?

It depends on the state. Of the 22 states with a published fee-for-service rate, the median is $38.26. Montana pays the most ($48.75) and Kansas the least ($12.00).

Which state pays the highest Medicaid rate for L8032?

Montana, at $48.75, effective 2026-01-01.

Do managed-care plans pay the same rate for L8032?

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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