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L5971 Medicaid reimbursement rates by state

All lower extremity prosthesis, solid ankle cushion heel. 42 state Medicaid programs publish a fee-for-service rate for L5971 at the physician psychologist level. Rates run from $135.90 in Georgia to $341.73 in Hawaii, with a median of $214.32.

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

States publishing
42
Median rate
$214.32units vary by state
Highest
$341.73Hawaii
Medicare (non-facility)
—not on the physician fee schedule

L5971 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
HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service$341.73since 2026-06-01——Plans negotiate; applies out of network—Medicaid Fee-For-Service (FFS) Fee Sched
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$331.51since 2026-01-01——Not classified—MaineCare Section 60, Medical Supplies a
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$290.79since 2026-07-01——Plans negotiate; applies out of network—Rates for Prostheses, Prosthetic Devices
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$285.66since 2024-07-01——Not classified—2026 Fee Schedule - Covered Procedures R
MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service)$277.97since 2026-01-01——Not classified—Montana Healthcare Programs fee schedule
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$277.88since 2026-01-01——Not classified—Vermont Medicaid Fee Schedule - DME Code
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$273.18since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP)$268.76since 2026-01-01——Plans negotiate; applies out of network—DMAP 2026 DME Fee Schedule
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$267.47since 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)$262.23since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$262.07since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$259.46since 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)$242.65since 2017-01-01——Plans negotiate; applies out of network—Provider Type 33, Durable Medical Equipm
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$235.52since 2026-01-01——Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$230.01since 2024-10-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$228.45since 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)$228.28since 2023-01-01——Plans negotiate; applies out of network—HFS DME Fee Schedule (effective 2023-01-
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$225.70since 2021-07-01——Plans negotiate; applies out of network—HCA Prosthetics and orthotics fee schedu
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$220.41since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$215.29since 2025-06-04——Not classified—Arkansas Medicaid Prosthetics (includes
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$215.01since 2026-04-01——Plans must pay at least this—BMS DME 2026 Rural Fee Schedule Effectiv
Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service)$213.63since 2012-07-01——Plans negotiate; applies out of network—RI Medicaid Interactive Fee For Service
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$211.75since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$205.36since 2026-07-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$205.31since 2010-07-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Prost
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$204.02since 2008-07-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Durable
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$202.57since 2012-01-01——Plans negotiate; applies out of network—DMAS procedure fee file hcpcmedical.csv
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$200.87since 2024-07-01——Not classified—SCDHHS Durable Medical Equipment (DME) F
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$198.93since 2026-07-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$198.90since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$197.93since 2026-01-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$197.23since 2013-03-01——Not classified—CMAP fee schedule: 10/01/2026 MEDS - Pro
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$195.05since 2026-01-01——Plans must pay at least this—SoonerCare Durable Medical Equipment Rat
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$185.57since 2019-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Durable Medic
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$183.19since 2020-01-01——State sets the plan rate—KY Medicaid DME fee schedule (2020Medica
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$176.20since 2022-06-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$174.04since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$163.92since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$161.40——Plans negotiate; applies out of network—NC Medicaid fee schedule 'Orthotics and
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$158.36since 2018-09-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$139.56since 2026-05-20——Not classified—EPSDT Referral (DME) Fee Schedule (REF-0
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$135.90since 2016-07-01——Plans negotiate; applies out of network—Orthotic and Prosthetic Fee Schedule - E

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 L5971?

It depends on the state. Of the 42 states with a published fee-for-service rate, the median is $214.32. Hawaii pays the most ($341.73) and Georgia the least ($135.90).

Which state pays the highest Medicaid rate for L5971?

Hawaii, at $341.73, effective 2026-06-01.

Do managed-care plans pay the same rate for L5971?

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.

Related Equipment & supplies codes

L0120Cervical, flexible, non-adjustable, prefabricated · 45 statesL0130Cervical, flexible, thermoplastic collar, molded to patient · 45 statesL0140Cervical, semi-rigid, adjustable (plastic collar) · 45 statesL0150Cervical, semi-rigid, adjustable molded chin cup · 45 statesL0172Cervical, collar, semi-rigid thermoplastic foam, two-piece · 45 statesL0174Cervical, collar, semi-rigid, thermoplastic foam · 45 statesL0200Cervical, multiple post collar · 45 statesL0220Thoracic, rib belt, custom fabricated · 45 statesL0450Tlso, flexible, provides trunk support · 45 statesL0472Tlso, triplanar control, hyperextension · 45 statesL0482Tlso, triplanar control · 45 statesL0484Tlso, triplanar control · 45 states
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