Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for L0636. 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
42
Median % of Medicare
74.1%
Rate range
$271.88 - $2,022.08
L0636 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $1,016.02 | 55.3% | -- | 2026 |
| Arkansas | $1,280.38* | 69.6% | -- | 2026 |
| Arizona | $2,022.08 | 110% | -- | 2026 |
| California | $1,137.77 | 61.9% | -- | 2026 |
| Colorado | $1,361.77 | 74.1% | Required | 2026 |
| Connecticut | $950.89 | 51.7% | Required | 2017 |
| District of Columbia | $1,302.65 | 70.8% | Required | 2026 |
| Hawaii | $1,070.07 | 58.2% | -- | 2025 |
| Iowa | $1,351.14 | 73.5% | -- | 2024 |
| Idaho | $1,427.87 | 77.6% | Not required | 2026 |
| Illinois | $1,353.96 | 73.6% | -- | 2026 |
| Indiana | $1,633.55 | 88.8% | -- | 2026 |
| Kansas | $1,618.52 | 88% | -- | 2026 |
| Kentucky | $1,143.02 | 62.2% | -- | 2026 |
| Massachusetts | $1,588.01 | 86.4% | -- | 2026 |
| Maryland | $1,384.06 | 75.3% | Required | 2026 |
| Maine | $1,810.39 | 98.4% | -- | 2026 |
| Michigan | $1,233.00 | 67% | -- | 2026 |
| Minnesota | $1,666.22 | 90.6% | Conditional | 2026 |
| Missouri | $1,365.35* | 74.2% | Not required | 2019 |
| Mississippi | $1,551.02* | 84.3% | -- | 2026 |
| Montana | $1,914.09 | 104.1% | Required | 2026 |
| North Carolina | $1,258.56 | 68.4% | -- | 2025 |
| North Dakota | $1,577.99 | 85.8% | Required | 2026 |
| Nebraska | $1,737.11 | 94.5% | -- | 2026 |
| New Hampshire | $1,559.96 | 84.8% | Not required | 2026 |
| New Jersey | $1,213.93 | 66% | Not required | 2026 |
| New Mexico | $1,624.70 | 88.4% | -- | 2025 |
| Nevada | $1,768.36 | 96.2% | -- | 2024 |
| New York | $1,046.71 | 56.9% | -- | 2026 |
| Ohio | $271.88 | 14.8% | -- | 2010 |
| Oklahoma | $1,160.03 | 63.1% | -- | 2026 |
| Pennsylvania | $853.32 | 46.4% | -- | 2007 |
| South Carolina | $1,566.34 | 85.2% | -- | 2024 |
| Texas | $1,085.59* | 59% | -- | 2006 |
| Utah | $1,369.82* | 74.5% | Required | 2026 |
| Virginia | $1,465.48 | 79.7% | -- | 2026 |
| Vermont | $1,517.53 | 82.5% | -- | 2026 |
| Washington | $1,242.08 | 67.5% | -- | 2026 |
| Wisconsin | $1,102.38 | 59.9% | -- | 2008 |
| West Virginia | $1,302.65 | 70.8% | -- | 2026 |
| Wyoming | $1,178.56 | 64.1% | Required | 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 L0636?
42 state Medicaid programs publish a fee-for-service rate for L0636 (lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, anterior panel, pendulous abdomen design, custom fabricated), ranging from $271.88 in Ohio to $2,022.08 in Arizona, with a median of 74.1% of the national Medicare amount. The full table on this page lists every publishing state's current rate.
Which state pays the most for L0636?
Arizona publishes the highest Medicaid rate for L0636 at $2,022.08 (110% of the national Medicare amount). Ohio publishes the lowest at $271.88.
Does L0636 require prior authorization under Medicaid?
9 of the 42 publishing states flag L0636 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".