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L8512 Medicaid reimbursement rates by state

Gelatin capsules or equivalent. 14 state Medicaid programs publish a fee-for-service rate for L8512 at the nurse midwife level. Rates run from $1.42 in Kentucky to $2.68 in Minnesota, with a median of $2.01.

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

States publishing
14
Median rate
$2.01units vary by state
Highest
$2.68Minnesota
Medicare (non-facility)
—not on the physician fee schedule

L8512 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
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$2.68since 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)$2.63since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$2.26since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$2.20since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$2.19since 2024-07-01——Not classified—SCDHHS Durable Medical Equipment (DME) F
ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$2.17since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$2.03since 2026-01-01——Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$1.98since 2005-02-07——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$1.96since 2012-01-01——Plans negotiate; applies out of network—DMAS procedure fee file hcpcmedical.csv
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$1.79since 2019-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Durable Medic
IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$1.78since 2024-07-01——State sets the plan rate—Iowa Medicaid fee schedule #08 PHARMACY
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$1.69since 2022-06-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$1.63since 2007-05-01——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)$1.42since 2020-01-01——State sets the plan rate—KY Medicaid DME fee schedule (2020Medica

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 L8512?

It depends on the state. Of the 14 states with a published fee-for-service rate, the median is $2.01. Minnesota pays the most ($2.68) and Kentucky the least ($1.42).

Which state pays the highest Medicaid rate for L8512?

Minnesota, at $2.68, effective 2026-01-01.

Do managed-care plans pay the same rate for L8512?

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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