L6370 Medicaid reimbursement rate by state (2026)
Interscapular thoracic, passive restoration. Medicaid pays a median of $2,074.62 for L6370 across 48 states, from $676.53 in Florida to $4,390.12 in Alaska.
- States publishing
- 48
- National median
- $2,074.62units vary by state
- Lowest
- $676.53Florida
- Highest
- $4,390.12Alaska
What does Medicaid pay for L6370?
48 state Medicaid programs publish a fee-for-service rate for L6370. The national median is $2,074.62 (units differ between states). Alaska pays the most, $4,390.12, and Florida the least, $676.53, a 6.5x spread.
L6370 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 48 states with every variant, modifier and effective date.
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 L6370, 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 48 states list more than one rate for L6370, 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 48 states, 2 publish L6370 per unit, and 46 schedules print no unit at all (a flat amount per service).
- Per hour. L6370 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 L6370, 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.
Why L6370 rates differ between states
Published rates for L6370 run from $676.53 in Florida to $4,390.12 in Alaska, a 6.5x gap in the same unit. Half the states pay more than the median of $2,074.62 and half pay less. The usual reasons for a spread like this in equipment & supplies rates:
- 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.
- Many states set equipment and supply fees as a percentage of the Medicare DMEPOS fee schedule, at different percentages and from different years.
Timing matters too. 25 states set the current rate for L6370 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.
What managed-care plans pay for L6370
No managed-care plan publishes what it pays for L6370. What is public is the rule each state's plan contracts set, and that rule decides how much the published rate matters when you contract with a plan.
In 9 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 15 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 (7 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 (2 states). 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.
Units and billing for L6370
L6370 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.
Pricing modifiers decide which amount applies: NU for a new purchase, RR for a monthly rental and UE for used equipment. 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.
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.
Frequently asked questions
What does Medicaid pay for L6370?
It depends on the state. Of the 48 states with a published fee-for-service rate, the median is $2,074.62. Alaska pays the most ($4,390.12) and Florida the least ($676.53).
Which state pays the highest Medicaid rate for L6370?
Alaska, at $4,390.12, effective 2026-01-01.
Which state pays the lowest Medicaid rate for L6370?
Florida, at $676.53, effective 2026-07-01.
What unit is L6370 billed in?
Of the 48 states, 2 publish L6370 per unit, and 46 schedules print no unit at all (a flat amount per service).
Do managed-care plans pay the same rate for L6370?
Not necessarily. In 9 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 15 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.