L7191 Medicaid reimbursement rates by state
Electronic elbow, child, variety village or equal. 36 state Medicaid programs publish a fee-for-service rate for L7191 at the nurse midwife level. Rates run from $2,400.00 in Alabama to $14,577.32 in New Mexico, with a median of $9,674.94.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 36
- Median rate
- $9,674.94units vary by state
- Highest
- $14,577.32New Mexico
- Medicare (non-facility)
- —not on the physician fee schedule
L7191 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.
| State | Medicaid rate | Unit | Per hour | Managed-care plans | % of Medicare | Source |
|---|---|---|---|---|---|---|
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $14,577.32since 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) | $14,510.42since 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) | $13,769.77since 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) | $13,499.77since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services) | $13,059.38since 2026-01-01 | — | — | Not classified | — | South Dakota Medicaid DME fee schedule ( |
| MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service) | $12,542.82since 2026-01-01 | — | — | Not classified | — | MaineCare Section 60, Medical Supplies a |
| AlaskaAny qualified provider (rate does not vary by provider) · Alaska Medicaid (fee-for-service, Department of Health) | $12,313.58since 2026-01-01 | — | — | Not classified | — | Alaska Medicaid DMEPOS Interim Fee Sched |
| DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP) | $12,088.38since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | DMAP 2026 Physician Fee Schedule |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $11,002.10since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Rates for Prostheses, Prosthetic Devices |
| TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP) | $10,954.94since 2010-07-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Prost |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $10,807.80since 2024-07-01 | — | — | Not classified | — | 2026 Fee Schedule - Covered Procedures R |
| HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service | $10,757.36since 2026-06-01 | — | — | Plans negotiate; applies out of network | — | Medicaid Fee-For-Service (FFS) Fee Sched |
| VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA) | $10,513.83since 2026-01-01 | — | — | Not classified | — | Vermont Medicaid Fee Schedule - DME Code |
| KansasAny qualified provider (rate does not vary by provider) · Kansas Medicaid QMB (Qualified Medicare Beneficiary) KMAP fee schedule | $10,386.81since 2026-07-01 | — | — | Not classified | — | KMAP Fee Schedule QMB Medicaid (FeeSched |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $10,275.12since 2026-01-01 | — | — | Not classified | — | Maryland Medicaid DME/DMS/Oxygen, Prosth |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $10,189.63since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Medical Suppliers/Orthotists/Prost |
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service) | $9,740.16since 2025-06-04 | — | — | Not classified | — | Arkansas Medicaid Prosthetics (includes |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $9,679.17since 2026-07-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services) | $9,670.70since 2026-04-01 | — | — | Plans must pay at least this | — | BMS DME 2026 Rural Fee Schedule Effectiv |
| ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $9,480.50since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Durable |
| WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health) | $9,267.73since 2021-01-01 | — | — | Not classified | — | Wyoming Medicaid Downloadable Fee Schedu |
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $9,110.98since 2012-01-01 | — | — | Plans negotiate; applies out of network | — | DMAS procedure fee file hcpcmedical.csv |
| MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service) | $9,052.65since 2026-07-01 | — | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, Septembe |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $8,875.15since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | ODM DMEPOS combined payment schedules (a |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $8,793.08since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Child Health Plan Plus FY 2026-2027 Fee |
| IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $8,779.66since 2024-07-01 | — | — | State sets the plan rate | — | Iowa Medicaid fee schedule #08 PHARMACY |
| WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service | $8,504.70since 2021-07-01 | — | — | Plans negotiate; applies out of network | — | HCA Prosthetics and orthotics fee schedu |
| Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service) | $8,082.75since 2012-07-01 | — | — | Plans negotiate; applies out of network | — | RI Medicaid Interactive Fee For Service |
| LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service) | $8,071.80since 2012-07-01 | — | — | Plans must pay at least this | — | Louisiana Medicaid Durable Medical Equip |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $7,344.83since 2013-03-01 | — | — | Not classified | — | CMAP fee schedule: 10/01/2026 MEDS - Pro |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $7,070.40since 2020-01-01 | — | — | State sets the plan rate | — | KY Medicaid DME fee schedule (2020Medica |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $6,989.33since 2008-07-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Durable |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $6,340.00since 1989-01-01 | — | — | Plans negotiate; applies out of network | — | PA DHS PROMISe Outpatient Fee Schedule ( |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $6,185.12since 2016-07-01 | — | — | Plans negotiate; applies out of network | — | Orthotic and Prosthetic Fee Schedule - E |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $4,706.24since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | Medi-Cal Rates (Rates files zip: rates_d |
| AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules) | $2,400.00since 2026-05-20 | — | — | Not classified | — | EPSDT Referral (DME) Fee Schedule (REF-0 |
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 L7191?
It depends on the state. Of the 36 states with a published fee-for-service rate, the median is $9,674.94. New Mexico pays the most ($14,577.32) and Alabama the least ($2,400.00).
Which state pays the highest Medicaid rate for L7191?
New Mexico, at $14,577.32, effective 2025-01-01.
Do managed-care plans pay the same rate for L7191?
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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Track L7191 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.