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L8681 Medicaid reimbursement rates by state

Patient programmer (external) for use with implantable.... 9 state Medicaid programs publish a fee-for-service rate for L8681 at the nurse midwife level. Rates run from $702.07 in Colorado to $1,404.38 in Minnesota, with a median of $1,106.51.

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

States publishing
9
Median rate
$1,106.51units vary by state
Highest
$1,404.38Minnesota
Medicare (non-facility)
—not on the physician fee schedule

L8681 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)$1,404.38since 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)$1,376.84since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$1,198.61since 2023-01-01——Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2023-01-
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$1,138.02since 2024-01-01——Plans must pay at least this—DMAS procedure fee file hcpcmedical.csv
ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$1,106.51since 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)$1,035.86since 2026-01-01——Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$1,003.38since 2013-03-01——Not classified—CMAP fee schedule: 10/01/2026 MEDS - Pro
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$926.72since 2008-01-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Dmepo
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$702.07since 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 L8681?

It depends on the state. Of the 9 states with a published fee-for-service rate, the median is $1,106.51. Minnesota pays the most ($1,404.38) and Colorado the least ($702.07).

Which state pays the highest Medicaid rate for L8681?

Minnesota, at $1,404.38, effective 2026-01-01.

Do managed-care plans pay the same rate for L8681?

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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