Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for L0455. Full schedules include every locality, modifier, and age-band variant.
- Every code on all 51 published schedules
- Full-schedule CSV export and state network lists
- Email alerts when a state changes its rates
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Publishing states
40
Median % of Medicare
104.9%
Rate range
$94.48 - $374.47
L0455 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arkansas | $254.66* | 101.8% | -- | 2026 |
| Arizona | $234.97 | 93.9% | -- | 2026 |
| California | $255.37 | 102.1% | -- | 2026 |
| Colorado | $290.50 | 116.1% | -- | 2026 |
| District of Columbia | $236.34 | 94.5% | Not required | 2026 |
| Florida | $187.90 | 75.1% | -- | 2026 |
| Hawaii | $319.22 | 127.6% | -- | 2025 |
| Iowa | $271.10 | 108.4% | -- | 2024 |
| Idaho | $296.08 | 118.3% | Not required | 2026 |
| Illinois | $262.46 | 104.9% | -- | 2026 |
| Indiana | $135.90 | 54.3% | -- | 2026 |
| Kansas | $211.26 | 84.4% | -- | 2026 |
| Kentucky | $328.83 | 131.4% | -- | 2026 |
| Louisiana | $284.96 | 113.9% | -- | 2026 |
| Massachusetts | $203.81 | 81.5% | -- | 2026 |
| Maine | $342.69 | 137% | -- | 2026 |
| Michigan | $257.36 | 102.9% | -- | 2026 |
| Minnesota | $264.08 | 105.5% | -- | 2026 |
| Missouri | $286.25* | 114.4% | Not required | 2019 |
| Mississippi | $279.16* | 111.6% | -- | 2026 |
| Montana | $350.13 | 139.9% | Not required | 2026 |
| North Carolina | $278.19 | 111.2% | -- | 2025 |
| North Dakota | $300.16 | 120% | Not required | 2026 |
| Nebraska | $374.47 | 149.7% | -- | 2026 |
| New Hampshire | $229.19 | 91.6% | Not required | 2026 |
| New Jersey | $165.44 | 66.1% | Not required | 2026 |
| New Mexico | $247.34 | 98.9% | -- | 2025 |
| Nevada | $322.71 | 129% | -- | 2019 |
| New York | $241.81 | 96.6% | -- | 2026 |
| Ohio | $180.00 | 71.9% | -- | 2022 |
| Oklahoma | $244.25 | 97.6% | -- | 2026 |
| Pennsylvania | $255.38 | 102.1% | -- | 2014 |
| South Carolina | $346.21 | 138.4% | -- | 2019 |
| Texas | $246.59* | 98.6% | -- | 2014 |
| Utah | $94.48* | 37.8% | Not required | 2026 |
| Virginia | $259.23 | 103.6% | -- | 2023 |
| Vermont | $286.48 | 114.5% | -- | 2026 |
| Washington | $312.67 | 125% | -- | 2026 |
| Wisconsin | $199.99 | 79.9% | -- | 2014 |
| Wyoming | $290.14 | 116% | -- | 2021 |
Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Rows marked * are representative published variants or methodology-derived rates. "--" in the prior-auth column means the state publishes no PA flag.
Related dme & supplies codes
- A2001 - Innovamatrix ac, per square centimeter (add-on, list separately in addition to primary procedure)
- A2002 - Mirragen advanced wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)
- A2005 - Microlyte matrix, per square centimeter (add-on, list separately in addition to primary procedure)
- A2006 - Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)
- A2007 - Restrata, per square centimeter (add-on, list separately in addition to primary procedure)
- A2008 - Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)
- A2009 - Symphony, per square centimeter (add-on, list separately in addition to primary procedure)
- A2010 - Apis, per square centimeter (add-on, list separately in addition to primary procedure)
All 80 codes from L0112 to L0984 or every dme & supplies code by number.
Frequently asked questions
How much does Medicaid pay for L0455?
40 state Medicaid programs publish a fee-for-service rate for L0455 (tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf), ranging from $94.48 in Utah to $374.47 in Nebraska, with a median of 104.9% of the national Medicare amount. The full table on this page lists every publishing state's current rate.
Which state pays the most for L0455?
Nebraska publishes the highest Medicaid rate for L0455 at $374.47 (149.7% of the national Medicare amount). Utah publishes the lowest at $94.48.
Does L0455 require prior authorization under Medicaid?
No publishing state flags L0455 with a prior-authorization indicator on its fee schedule. Absence of a flag means the state publishes none, not that PA is never required - confirm through the state's provider manual.