Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for L0631. 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
43
Median % of Medicare
75%
Rate range
$483.98 - $1,821.54
L0631 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $664.74 | 52.9% | -- | 2026 |
| Arkansas | $979.97* | 78% | -- | 2026 |
| Arizona | $1,146.88 | 91.3% | -- | 2026 |
| California | $645.31 | 51.4% | -- | 2026 |
| Colorado | $909.22 | 72.4% | Required | 2026 |
| Connecticut | $658.72 | 52.5% | Required | 2017 |
| District of Columbia | $985.10 | 78.5% | Required | 2026 |
| Florida | $1,009.27 | 80.4% | -- | 2026 |
| Hawaii | $483.98 | 38.5% | -- | 2025 |
| Iowa | $838.42 | 66.8% | -- | 2024 |
| Idaho | $1,063.91 | 84.7% | Not required | 2026 |
| Indiana | $1,236.86 | 98.5% | -- | 2026 |
| Kansas | $1,004.37 | 80% | -- | 2026 |
| Kentucky | $830.92 | 66.2% | -- | 2026 |
| Louisiana | $688.54 | 54.8% | -- | 2026 |
| Massachusetts | $942.24 | 75% | -- | 2026 |
| Maryland | $1,046.67 | 83.4% | Required | 2026 |
| Maine | $1,231.38 | 98.1% | -- | 2026 |
| Michigan | $933.58 | 74.4% | -- | 2026 |
| Minnesota | $1,261.60 | 100.5% | Conditional | 2026 |
| Missouri | $847.25* | 67.5% | Not required | 2019 |
| Mississippi | $1,014.78* | 80.8% | -- | 2026 |
| Montana | $1,278.01 | 101.8% | Required | 2026 |
| North Carolina | $823.42 | 65.6% | -- | 2025 |
| North Dakota | $955.24 | 76.1% | Not required | 2026 |
| Nebraska | $1,077.93 | 85.8% | -- | 2026 |
| New Hampshire | $1,061.06 | 84.5% | Not required | 2026 |
| New Jersey | $861.97 | 68.6% | Not required | 2026 |
| New Mexico | $1,821.54 | 145.1% | -- | 2025 |
| Nevada | $1,002.96 | 79.9% | -- | 2024 |
| New York | $814.71 | 64.9% | -- | 2026 |
| Ohio | $835.85 | 66.6% | Not required | 2024 |
| Oklahoma | $887.86 | 70.7% | -- | 2026 |
| Pennsylvania | $645.31 | 51.4% | -- | 2007 |
| South Carolina | $1,024.80 | 81.6% | -- | 2024 |
| Texas | $830.85* | 66.2% | -- | 2006 |
| Utah | $914.61* | 72.8% | Required | 2026 |
| Virginia | $1,108.24 | 88.3% | -- | 2026 |
| Vermont | $1,032.19 | 82.2% | -- | 2026 |
| Washington | $925.47 | 73.7% | -- | 2026 |
| Wisconsin | $834.70 | 66.5% | -- | 2008 |
| West Virginia | $985.10 | 78.5% | -- | 2026 |
| Wyoming | $786.90 | 62.7% | -- | 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 L0631?
43 state Medicaid programs publish a fee-for-service rate for L0631 (lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise), ranging from $483.98 in Hawaii to $1,821.54 in New Mexico, with a median of 75% of the national Medicare amount. The full table on this page lists every publishing state's current rate.
Which state pays the most for L0631?
New Mexico publishes the highest Medicaid rate for L0631 at $1,821.54 (145.1% of the national Medicare amount). Hawaii publishes the lowest at $483.98.
Does L0631 require prior authorization under Medicaid?
7 of the 43 publishing states flag L0631 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".