Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for L1821. 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
26
Median % of Medicare
85.2%
Rate range
$100.00 - $186.30
L1821 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arkansas | $158.29* | 94.7% | -- | 2026 |
| Arizona | $169.31 | 101.3% | -- | 2026 |
| Colorado | $126.80 | 75.9% | -- | 2026 |
| Connecticut | $142.35 | 85.2% | -- | 2024 |
| District of Columbia | $140.26 | 83.9% | Not required | 2026 |
| Idaho | $143.22 | 85.7% | Not required | 2026 |
| Indiana | $171.23 | 102.5% | -- | 2026 |
| Kansas | $122.02 | 73% | -- | 2026 |
| Massachusetts | $118.50 | 70.9% | -- | 2026 |
| Maine | $174.92 | 104.7% | -- | 2026 |
| Michigan | $129.24 | 77.4% | -- | 2026 |
| Minnesota | $174.65 | 104.5% | Conditional | 2026 |
| Mississippi | $119.19* | 71.3% | -- | 2026 |
| Montana | $162.95 | 97.5% | Not required | 2026 |
| North Dakota | $186.30 | 111.5% | Not required | 2026 |
| New Hampshire | $100.48 | 60.1% | Not required | 2026 |
| New Jersey | $116.08 | 69.5% | Required | 2026 |
| New Mexico | $158.29 | 94.7% | -- | 2024 |
| Nevada | $178.22 | 106.7% | -- | 2024 |
| Ohio | $100.00 | 59.9% | Not required | 2024 |
| Oklahoma | $115.73 | 69.3% | -- | 2026 |
| Texas | $121.57* | 72.8% | -- | 2024 |
| Utah | $116.62* | 69.8% | Not required | 2026 |
| Virginia | $157.79 | 94.4% | -- | 2026 |
| Vermont | $146.62 | 87.8% | -- | 2026 |
| Wisconsin | $133.78 | 80.1% | -- | 2024 |
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 89 codes from L1000 to L1990 or every dme & supplies code by number.
Frequently asked questions
How much does Medicaid pay for L1821?
26 state Medicaid programs publish a fee-for-service rate for L1821 (knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf), ranging from $100.00 in Ohio to $186.30 in North Dakota, with a median of 85.2% of the national Medicare amount. The full table on this page lists every publishing state's current rate.
Which state pays the most for L1821?
North Dakota publishes the highest Medicaid rate for L1821 at $186.30 (111.5% of the national Medicare amount). Ohio publishes the lowest at $100.00.
Does L1821 require prior authorization under Medicaid?
2 of the 26 publishing states flag L1821 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".