Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for L0458. 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
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Publishing states
41
Median % of Medicare
76.9%
Rate range
$404.18 - $1,274.76
L0458 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $577.50 | 53% | -- | 2026 |
| Arkansas | $851.33* | 78.1% | -- | 2026 |
| Arizona | $996.33 | 91.4% | -- | 2026 |
| California | $560.62 | 51.4% | -- | 2026 |
| Colorado | $886.64 | 81.3% | Required | 2026 |
| District of Columbia | $855.80 | 78.5% | Required | 2026 |
| Florida | $586.18 | 53.7% | -- | 2026 |
| Hawaii | $420.46 | 38.6% | -- | 2025 |
| Iowa | $737.75 | 67.6% | -- | 2024 |
| Idaho | $924.27 | 84.8% | Not required | 2026 |
| Illinois | $832.38 | 76.3% | -- | 2026 |
| Indiana | $1,074.57 | 98.5% | -- | 2026 |
| Kansas | $872.52 | 80% | -- | 2026 |
| Kentucky | $946.01 | 86.7% | -- | 2026 |
| Massachusetts | $818.56 | 75.1% | -- | 2026 |
| Maryland | $909.29 | 83.4% | -- | 2026 |
| Maine | $1,069.75 | 98.1% | -- | 2026 |
| Michigan | $811.08 | 74.4% | -- | 2026 |
| Minnesota | $1,096.06 | 100.5% | Conditional | 2026 |
| Missouri | $651.11* | 59.7% | Not required | 2019 |
| Mississippi | $881.58* | 80.8% | -- | 2026 |
| Montana | $1,108.06 | 101.6% | Required | 2026 |
| North Carolina | $715.35 | 65.6% | -- | 2025 |
| North Dakota | $1,274.76 | 116.9% | Required | 2026 |
| Nebraska | $936.45 | 85.9% | -- | 2026 |
| New Hampshire | $921.77 | 84.5% | Not required | 2026 |
| New Jersey | $748.83 | 68.7% | Not required | 2026 |
| New Mexico | $1,080.27 | 99.1% | -- | 2025 |
| Nevada | $829.83 | 76.1% | -- | 2017 |
| New York | $404.18 | 37.1% | -- | 2026 |
| Ohio | $839.01 | 76.9% | -- | 2026 |
| Oklahoma | $771.32 | 70.7% | -- | 2026 |
| Pennsylvania | $700.77 | 64.3% | -- | 2004 |
| South Carolina | $890.29 | 81.6% | -- | 2024 |
| Texas | $661.15* | 60.6% | -- | 2003 |
| Utah | $792.98* | 72.7% | Not required | 2026 |
| Virginia | $962.78 | 88.3% | -- | 2026 |
| Vermont | $896.70 | 82.2% | -- | 2026 |
| Washington | $804.00 | 73.7% | -- | 2026 |
| Wisconsin | $596.41 | 54.7% | -- | 2008 |
| Wyoming | $682.26 | 62.6% | -- | 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 L0458?
41 state Medicaid programs publish a fee-for-service rate for L0458 (tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment), ranging from $404.18 in New York to $1,274.76 in North Dakota, with a median of 76.9% of the national Medicare amount. The full table on this page lists every publishing state's current rate.
Which state pays the most for L0458?
North Dakota publishes the highest Medicaid rate for L0458 at $1,274.76 (116.9% of the national Medicare amount). New York publishes the lowest at $404.18.
Does L0458 require prior authorization under Medicaid?
5 of the 41 publishing states flag L0458 as requiring prior authorization (always or conditionally) on their fee schedules. States without a flag publish no PA indicator for this code - that means "not published", not "no PA required".