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L4050 Medicaid reimbursement rates by state

Replace molded calf lacer. 48 state Medicaid programs publish a fee-for-service rate for L4050 at the nurse midwife level. Rates run from $111.00 in Alabama to $1,211.76 in Alaska, with a median of $391.44.

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

States publishing
48
Median rate
$391.44units vary by state
Highest
$1,211.76Alaska
Medicare (non-facility)
—not on the physician fee schedule

L4050 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
AlaskaAny qualified provider (rate does not vary by provider) · Alaska Medicaid (fee-for-service, Department of Health)$1,211.76⚠ over 3× mediansince 2026-01-01——Not classified—Alaska Medicaid DMEPOS Interim Fee Sched
HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service$1,058.62since 2026-06-01——Plans negotiate; applies out of network—Medicaid Fee-For-Service (FFS) Fee Sched
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$595.90since 2022-06-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$577.81since 2026-01-01——Not classified—MaineCare Section 60, Medical Supplies a
ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$529.95since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$506.83since 2026-07-01——Plans negotiate; applies out of network—Rates for Prostheses, Prosthetic Devices
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$505.37since 2026-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$497.88since 2024-07-01——Not classified—2026 Fee Schedule - Covered Procedures R
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$495.46since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$493.84since 2026-07-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$490.68since 2017-01-01——Plans negotiate; applies out of network—Provider Type 33, Durable Medical Equipm
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$484.34since 2026-01-01——Not classified—Vermont Medicaid Fee Schedule - DME Code
MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service)$474.40since 2026-01-01——Not classified—Montana Healthcare Programs fee schedule
DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP)$474.40since 2026-01-01——Plans negotiate; applies out of network—DMAP 2026 Physician Fee Schedule
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$465.10since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$459.76since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$442.78since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$437.79since 2024-10-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$429.59since 2021-07-01——Plans negotiate; applies out of network—HCA Prosthetics and orthotics fee schedu
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$428.38since 2026-07-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$426.96since 2026-01-01Each—Plans must pay at least this—DMAS procedure fee file hcpcmedical.csv
South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services)$426.96since 2026-01-01——Not classified—South Dakota Medicaid DME fee schedule (
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$403.24since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$399.60since 2025-01-01——Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2025-01-
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$383.28since 2024-07-01——Not classified—SCDHHS Durable Medical Equipment (DME) F
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$379.52since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$379.52since 2026-04-01——Plans must pay at least this—BMS DME 2026 Rural Fee Schedule Effectiv
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$373.97since 2026-01-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service)$372.36since 2012-07-01——Plans negotiate; applies out of network—RI Medicaid Interactive Fee For Service
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$339.50since 2026-07-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$332.08since 2026-01-01——Plans must pay at least this—SoonerCare Durable Medical Equipment Rat
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$331.49since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health)$324.57since 2021-01-01——Not classified—Wyoming Medicaid Downloadable Fee Schedu
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$318.79since 2013-03-01——Not classified—CMAP fee schedule: 10/01/2026 MEDS - Pro
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$310.77since 2025-06-04——Not classified—Arkansas Medicaid Prosthetics (includes
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$307.97——Plans negotiate; applies out of network—NC Medicaid fee schedule 'Orthotics and
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$296.42since 2020-01-01——State sets the plan rate—KY Medicaid DME fee schedule (2020Medica
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$262.73since 2010-01-01Each—Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$259.31since 2016-07-01——Plans negotiate; applies out of network—Orthotic and Prosthetic Fee Schedule - E
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$257.83since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$257.56since 2019-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Durable Medic
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$257.54since 2012-07-01——Plans must pay at least this—Louisiana Medicaid Durable Medical Equip
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$232.55since 2026-03-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Ortho
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$219.32since 2008-07-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Durable
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$171.73since 2026-07-01——Plans negotiate; applies out of network—Durable Medical Equipment and Medical Su
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$140.00since 1988-10-01——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient 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)$115.00since 2024-07-01——State sets the plan rate—Iowa Medicaid fee schedule #08 PHARMACY
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$111.00since 2026-05-20——Not classified—EPSDT Referral (DME) Fee Schedule (REF-0

Rates marked ⚠ are more than three times the median for the same unit; they are published as shown but often reflect an office (non-facility) fee or a different scope of service. 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 L4050?

It depends on the state. Of the 48 states with a published fee-for-service rate, the median is $391.44. Alaska pays the most ($1,211.76) and Alabama the least ($111.00).

Which state pays the highest Medicaid rate for L4050?

Alaska, at $1,211.76, effective 2026-01-01.

Do managed-care plans pay the same rate for L4050?

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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