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L7040 Medicaid reimbursement rates by state

Prehensile actuator, switch controlled. 32 state Medicaid programs publish a fee-for-service rate for L7040 at the nurse midwife level. Rates run from $1,057.46 in Florida to $4,511.59 in New Mexico, with a median of $2,771.49.

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

States publishing
32
Median rate
$2,771.49units vary by state
Highest
$4,511.59New Mexico
Medicare (non-facility)
—not on the physician fee schedule

L7040 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)$4,511.59since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$3,745.35since 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)$3,671.91since 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)$3,557.00since 2026-01-01——Not classified—MaineCare Section 60, Medical Supplies a
MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service)$3,451.37since 2026-01-01——Not classified—Montana Healthcare Programs fee schedule
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$3,390.49since 2010-07-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Prost
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$3,120.07since 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)$3,064.97since 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)$3,027.19since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$3,014.52since 2025-06-04——Not classified—Arkansas Medicaid Prosthetics (includes
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$2,981.60since 2026-01-01——Not classified—Vermont Medicaid Fee Schedule - DME Code
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$2,892.12since 2026-01-01——Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$2,891.59since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$2,849.12since 2026-04-01——Plans must pay at least this—BMS DME 2026 Rural Fee Schedule Effectiv
KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule$2,833.67since 2026-07-01——Not classified—KMAP Fee Schedule QMB Medicaid (FeeSched
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$2,771.56since 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$2,771.41since 2021-07-01——Plans negotiate; applies out of network—HCA Prosthetics and orthotics fee schedu
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$2,761.10since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$2,684.21since 2012-01-01——Plans negotiate; applies out of network—DMAS procedure fee file hcpcmedical.csv
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$2,614.71since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$2,498.18since 2012-07-01——Plans must pay at least this—Louisiana Medicaid Durable Medical Equip
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$2,478.01since 2008-07-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Durable
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$2,469.97since 2026-07-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$2,240.20since 2013-03-01——Not classified—CMAP fee schedule: 10/01/2026 MEDS - Pro
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$2,215.00since 2026-05-20——Not classified—EPSDT Referral (DME) Fee Schedule (REF-0
IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$2,194.85since 2024-07-01——State sets the plan rate—Iowa Medicaid fee schedule #08 PHARMACY
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$2,156.50since 2020-01-01——State sets the plan rate—KY Medicaid DME fee schedule (2020Medica
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$1,967.79since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$1,886.49since 2016-07-01——Plans negotiate; applies out of network—Orthotic and Prosthetic Fee Schedule - E
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$1,830.60since 1989-01-01——Plans negotiate; applies out of network—PA DHS PROMISe Outpatient Fee Schedule (
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$1,281.88since 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)$1,057.46since 2026-07-01——Plans negotiate; applies out of network—Durable Medical Equipment and Medical Su

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 L7040?

It depends on the state. Of the 32 states with a published fee-for-service rate, the median is $2,771.49. New Mexico pays the most ($4,511.59) and Florida the least ($1,057.46).

Which state pays the highest Medicaid rate for L7040?

New Mexico, at $4,511.59, effective 2025-01-01.

Do managed-care plans pay the same rate for L7040?

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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