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L6035 Medicaid reimbursement rates by state

Single prosthetic digit, mechanical. 5 state Medicaid programs publish a fee-for-service rate for L6035. Rates run from $5.23 in Arizona to $3,056.52 in Colorado, with a median of $1,614.12.

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

States publishing
5
Median rate
$1,614.12units vary by state
Highest
$3,056.52Colorado
Medicare (non-facility)
—not on the physician fee schedule

L6035 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
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$3,056.52since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service)$1,684.92since 2026-04-01——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)$1,614.12since 2026-04-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$1,291.74since 2026-04-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$5.23since 2026-10-01day—Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: DME rent

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 L6035?

It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $1,614.12. Colorado pays the most ($3,056.52) and Arizona the least ($5.23 per day).

Which state pays the highest Medicaid rate for L6035?

Colorado, at $3,056.52, effective 2026-07-01.

Do managed-care plans pay the same rate for L6035?

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

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