Skip to content
Billing code L1060 · Equipment & supplies

L1060 Medicaid reimbursement rate by state (2026)

Addition to ctlso or scoliosis orthosis, thoracic pad. Medicaid pays a median of $96.43 for L1060 across 50 states, from $39.44 in Iowa to $191.80 in Alaska.

Data as of Oct 5, 202650 statesEvery rate links to its official source

States publishing
50
National median
$96.43units vary by state
Lowest
$39.44Iowa
Highest
$191.80Alaska
Answer

What does Medicaid pay for L1060?

50 state Medicaid programs publish a fee-for-service rate for L1060. The national median is $96.43 (units differ between states). Alaska pays the most, $191.80, and Iowa the least, $39.44, a 4.9x spread.

State ranking

L1060 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 50 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Alaska Source · since 2026-01-01$191.80——Not classified—
2Hawaii Source · since 2026-06-01$167.61——Plans negotiate; applies out of network—
3Delaware Source · since 2026-01-01$138.32——Plans negotiate; applies out of network—
25Nebraska Source · since 2026-07-01$97.07——Plans negotiate; applies out of network—
26Vermont Source · since 2026-01-01$95.79——Not classified—
27South Carolina Source · since 2019-07-01$92.56——Not classified—
49New York Source · since 2022-06-01$45.45——Plans negotiate; applies out of network—
50Iowa Source · since 2018-09-01$39.44——Plans must pay at least this—
See all 50 states for L1060 — start free

42 more states, with every modifier and provider-type variant, rate history and the plan rule in each state. 14-day free trial, no credit card.

  • Source for every rate
  • Full rate history
  • CSV and API export

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; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Track L1060 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
Guide

How to read this table

  • Order. States are listed from the highest published rate to the lowest. No single unit is shared by 8 or more states for L1060, so the order is by published amount and is not a like-for-like rank.
  • Medicaid rate. The most the state's fee-for-service program pays for one unit, as published. 17 of the 50 states list more than one rate for L1060, by modifier, provider type or setting; the table shows the one that matches the provider level and setting used across states, without add-ons.
  • Unit. Of the 50 states, 3 publish L1060 per unit, and 47 schedules print no unit at all (a flat amount per service).
  • Per hour. L1060 is not billed in time units in these states, so no hourly figure is shown.
  • Managed-care plans. The rule the state sets for its plans on this rate. What each rule means is explained below.
  • % of Medicare. No Medicare physician fee schedule amount is on file for L1060, so there is no percentage.
  • Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.
Context

Why L1060 rates differ between states

Published rates for L1060 run from $39.44 in Iowa to $191.80 in Alaska, a 4.9x gap in the same unit. Half the states pay more than the median of $96.43 and half pay less. The usual reasons for a spread like this in equipment & supplies rates:

  • Many states set equipment and supply fees as a percentage of the Medicare DMEPOS fee schedule, at different percentages and from different years.
  • A single code can carry separate purchase, rental and used-equipment amounts, and states publish different subsets of them.
  • Some items are priced individually from the manufacturer's price or the supplier's invoice, so fewer states publish a fixed fee.

Timing matters too. 27 states set the current rate for L1060 in 2026 or later, while 16 states still pay a rate that took effect in 2022 or earlier. A state that has not updated its rate in years will drift down the ranking as others raise theirs.

Managed care

What managed-care plans pay for L1060

Most Medicaid members are in managed-care plans, and plans don't publish their provider fee schedules. For L1060, the public signal is the rule each state sets for its plans, recorded on each rate above.

In 10 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 24 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 16 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (24 states). In-network rates can be above or below the published rate. The published rate is the benchmark both sides know, and the fallback if no contract is signed.
  • Plans must pay at least the published rate (9 states). The published rate is your floor. Negotiate up from it, and if a plan pays less, the contract provision is the basis for a payment dispute.
  • The state sets the plan rate (1 state). There is little to negotiate on price. Contracting is about network participation, authorization and billing terms.

Plan-negotiated rates are never estimated here. To see the rule and its citation for a particular state, open that state's managed-care page, for example Alaska managed care.

Billing

Units and billing for L1060

L1060 is a HCPCS Level II orthotic and prosthetic code in the equipment & supplies line, billed mostly by durable medical equipment suppliers, orthotists, prosthetists and pharmacies. L codes cover orthotic and prosthetic devices. Each is paid per device, and some are priced individually from the supplier's invoice.

Units follow the code: per item, per pair, per box or per month of rental, so a per-unit comparison only holds when the states use the same unit. Pricing modifiers decide which amount applies: NU for a new purchase, RR for a monthly rental and UE for used equipment.

Before billing, confirm the rate, unit and any modifier with the state's current schedule or the plan: the amounts here are as published, not a guarantee of payment.

FAQ

Frequently asked questions

What does Medicaid pay for L1060?

It depends on the state. Of the 50 states with a published fee-for-service rate, the median is $96.43. Alaska pays the most ($191.80) and Iowa the least ($39.44).

Which state pays the highest Medicaid rate for L1060?

Alaska, at $191.80, effective 2026-01-01.

Which state pays the lowest Medicaid rate for L1060?

Iowa, at $39.44, effective 2018-09-01.

What unit is L1060 billed in?

Of the 50 states, 3 publish L1060 per unit, and 47 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for L1060?

Not necessarily. In 10 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 24 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 16 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.