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L4387 Medicaid reimbursement rates by state

Walking boot, non-pneumatic, with or without joints. 41 state Medicaid programs publish a fee-for-service rate for L4387 at the physician psychologist level. Rates run from $85.00 in Ohio to $281.31 in New Mexico, with a median of $144.20.

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

States publishing
41
Median rate
$144.20units vary by state
Highest
$281.31New Mexico
Medicare (non-facility)
—not on the physician fee schedule

L4387 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
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$281.31since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service)$196.98since 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)$194.86since 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)$191.04since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$190.16since 2026-01-01——Not classified—MaineCare Section 60, Medical Supplies a
DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP)$190.16since 2026-01-01——Plans negotiate; applies out of network—DMAP 2026 DME Fee Schedule
HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service$186.43since 2026-06-01——Plans negotiate; applies out of network—Medicaid Fee-For-Service (FFS) Fee Sched
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$171.14since 2026-01-01Each—Plans must pay at least this—DMAS procedure fee file hcpcmedical.csv
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$164.29since 2026-07-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$163.85since 2024-07-01——Not classified—2026 Fee Schedule - Covered Procedures R
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$161.64since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$159.40since 2026-01-01——Not classified—Vermont Medicaid Fee Schedule - DME Code
ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$159.32since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$158.27since 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)$156.71since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$155.13since 2026-07-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$151.34since 2025-06-04——Not classified—Arkansas Medicaid Prosthetics (includes
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$150.33since 2020-01-01——State sets the plan rate—KY Medicaid DME fee schedule (2020Medica
NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$147.53since 2019-11-01——Plans negotiate; applies out of network—Provider Type 33, Durable Medical Equipm
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$145.65since 2024-10-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$144.20since 2026-01-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$142.94since 2021-07-01——Plans negotiate; applies out of network—HCA Prosthetics and orthotics fee schedu
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$142.76since 2018-09-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$140.97since 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)$137.12since 2026-01-01——Plans must pay at least this—SoonerCare Durable Medical Equipment Rat
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$135.16since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$133.11since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$130.86since 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)$130.28since 2014-01-01——Plans must pay at least this—Louisiana Medicaid Durable Medical Equip
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$127.18since 2022-01-01——Plans must pay at least this—NC Medicaid fee schedule 'Nurse Practiti
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$125.56since 2026-07-01——Plans negotiate; applies out of network—Rates for Prostheses, Prosthetic Devices
Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service)$124.04since 2014-01-01——Plans negotiate; applies out of network—RI Medicaid Interactive Fee For Service
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$120.26since 2016-07-01——Plans negotiate; applies out of network—Orthotic and Prosthetic Fee Schedule - E
IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service)$116.75since 2019-07-24——Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2019-07-
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$116.74since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$114.90since 2026-07-01——Plans negotiate; applies out of network—Durable Medical Equipment and Medical Su
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$114.25since 2026-05-20——Not classified—EPSDT Referral (DME) Fee Schedule (REF-0
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$112.74since 2014-01-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Ortho
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$102.38since 2017-03-01——Not classified—CMAP fee schedule: 10/01/2026 MEDS - Pro
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$93.18since 2014-01-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Durable
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$85.00since 2021-10-01Each—Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a

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 L4387?

It depends on the state. Of the 41 states with a published fee-for-service rate, the median is $144.20. New Mexico pays the most ($281.31) and Ohio the least ($85.00 per Each).

Which state pays the highest Medicaid rate for L4387?

New Mexico, at $281.31, effective 2025-01-01.

Do managed-care plans pay the same rate for L4387?

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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