L0649 Medicaid Rate by State

Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), 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, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf

42 state Medicaid programs publish a fee-for-service rate for L0649 (lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), 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, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf), ranging from $78.13 in Utah to $328.25 in Wisconsin, with a median of 108.3% of the national Medicare amount.

Every state, kept current

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Publishing states

42

Median % of Medicare

108.3%

Rate range

$78.13 - $328.25

L0649 rates in every publishing state

StateMedicaid rate% of MedicarePrior authVintage
Alabama$206.6399.9%--2026
Arkansas$271.86*131.4%--2026
Arizona$194.3293.9%--2026
California$211.14102%--2026
Colorado$240.67116.3%--2026
Connecticut$190.7292.2%--2021
District of Columbia$195.4694.5%Not required2026
Hawaii$263.93127.6%--2025
Iowa$224.14108.3%--2024
Idaho$244.83118.3%Not required2026
Illinois$275.36133.1%--2026
Indiana$112.4054.3%--2026
Kansas$174.7284.4%--2026
Kentucky$271.88131.4%--2026
Louisiana$235.62113.9%--2026
Massachusetts$168.5481.5%--2026
Maryland$166.1480.3%--2026
Maine$283.37136.9%--2026
Michigan$212.82102.9%--2026
Minnesota$218.40105.5%--2026
Missouri$236.67*114.4%Not required2019
Mississippi$230.84*111.6%--2026
Montana$289.88140.1%Not required2026
North Carolina$230.01111.2%--2025
North Dakota$248.23120%Not required2026
Nebraska$309.60149.6%--2026
New Hampshire$189.5391.6%Not required2026
New Jersey$136.8266.1%Not required2026
New Mexico$204.5598.9%--2025
Nevada$266.82128.9%--2019
New York$199.9396.6%--2026
Ohio$180.0087%--2022
Oklahoma$201.9797.6%--2026
Pennsylvania$211.14102%--2014
South Carolina$286.26138.3%--2019
Texas$203.89*98.5%--2014
Utah$78.13*37.8%Required2026
Virginia$214.37103.6%--2023
Vermont$236.89114.5%--2026
Washington$258.51124.9%--2026
Wisconsin$328.25158.6%--2014
Wyoming$240.37116.2%--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 L0649?

42 state Medicaid programs publish a fee-for-service rate for L0649 (lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), 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, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf), ranging from $78.13 in Utah to $328.25 in Wisconsin, with a median of 108.3% of the national Medicare amount. The full table on this page lists every publishing state's current rate.

Which state pays the most for L0649?

Wisconsin publishes the highest Medicaid rate for L0649 at $328.25 (158.6% of the national Medicare amount). Utah publishes the lowest at $78.13.

Does L0649 require prior authorization under Medicaid?

1 of the 42 publishing states flag L0649 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".