L0492 Medicaid Rate by State

Tlso, sagittal-coronal control, modular segmented spinal system, three 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 and coronal planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment

40 state Medicaid programs publish a fee-for-service rate for L0492 (tlso, sagittal-coronal control, modular segmented spinal system, three 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 and coronal planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment), ranging from $41.12 in Hawaii to $614.59 in Minnesota, with a median of 77.3% of the national Medicare amount.

Every state, kept current

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Publishing states

40

Median % of Medicare

77.3%

Rate range

$41.12 - $614.59

L0492 rates in every publishing state

StateMedicaid rate% of MedicarePrior authVintage
Alabama$322.3052.8%--2026
Arkansas$475.13*77.8%--2026
Arizona$592.0897%--2026
California$333.1454.6%--2026
Colorado$331.4054.3%--2026
Connecticut$355.3658.2%Required2013
District of Columbia$484.6979.4%Required2026
Hawaii$41.126.7%--2025
Iowa$233.9938.3%--2024
Idaho$523.5285.7%Not required2026
Illinois$466.7576.4%--2026
Indiana$602.5498.7%--2026
Kansas$461.9475.7%--2026
Kentucky$402.8766%--2026
Massachusetts$463.8776%--2026
Maryland$514.9884.3%--2026
Maine$606.2299.3%--2026
Michigan$454.8074.5%--2026
Minnesota$614.59100.7%Conditional2026
Missouri$389.68*63.8%Not required2019
Mississippi$491.99*80.6%--2026
Montana$601.3498.5%Not required2026
Nebraska$495.7781.2%--2026
New Hampshire$522.3685.6%Not required2026
New Jersey$423.6369.4%Not required2026
New Mexico$602.9098.7%--2025
Nevada$493.1380.8%--2017
New York$360.3659%--2026
Ohio$475.2377.8%--2026
Oklahoma$430.4770.5%--2026
Pennsylvania$317.5052%--2007
South Carolina$496.8681.4%--2024
Texas$402.85*66%--2006
Utah$430.35*70.5%Not required2026
Virginia$545.2789.3%--2026
Vermont$508.1583.2%--2026
Washington$455.3974.6%--2026
Wisconsin$472.2077.3%--2008
West Virginia$484.6979.4%--2026
Wyoming$374.5661.3%--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

All 80 codes from L0112 to L0984 or every dme & supplies code by number.

Frequently asked questions

How much does Medicaid pay for L0492?

40 state Medicaid programs publish a fee-for-service rate for L0492 (tlso, sagittal-coronal control, modular segmented spinal system, three 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 and coronal planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment), ranging from $41.12 in Hawaii to $614.59 in Minnesota, with a median of 77.3% of the national Medicare amount. The full table on this page lists every publishing state's current rate.

Which state pays the most for L0492?

Minnesota publishes the highest Medicaid rate for L0492 at $614.59 (100.7% of the national Medicare amount). Hawaii publishes the lowest at $41.12.

Does L0492 require prior authorization under Medicaid?

3 of the 40 publishing states flag L0492 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".