Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for L1852. 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
40
Median % of Medicare
96.8%
Rate range
$246.09 - $935.02
L1852 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $723.25 | 109.7% | -- | 2026 |
| Arkansas | $654.89* | 99.3% | -- | 2026 |
| Arizona | $530.16 | 80.4% | -- | 2026 |
| California | $586.95 | 89% | -- | 2026 |
| Colorado | $638.20 | 96.8% | -- | 2026 |
| Connecticut | $545.10 | 82.6% | Required | 2025 |
| District of Columbia | $634.46 | 96.2% | Required | 2026 |
| Florida | $476.14 | 72.2% | -- | 2026 |
| Hawaii | $802.05 | 121.6% | -- | 2025 |
| Iowa | $611.17 | 92.7% | -- | 2024 |
| Idaho | $723.99 | 109.8% | Not required | 2026 |
| Indiana | $415.79 | 63% | -- | 2026 |
| Kansas | $505.70 | 76.7% | -- | 2026 |
| Kentucky | $745.04 | 113% | -- | 2026 |
| Louisiana | $588.54 | 89.2% | -- | 2026 |
| Massachusetts | $505.54 | 76.6% | -- | 2026 |
| Maryland | $398.79 | 60.5% | -- | 2026 |
| Maine | $850.63 | 129% | -- | 2026 |
| Michigan | $640.09 | 97% | -- | 2026 |
| Minnesota | $632.13 | 95.8% | Conditional | 2026 |
| Missouri | $776.23* | 117.7% | Not required | 2019 |
| Mississippi | $743.13* | 112.7% | -- | 2026 |
| Montana | $835.27 | 126.6% | Not required | 2026 |
| North Carolina | $662.21 | 100.4% | -- | 2025 |
| North Dakota | $246.09 | 37.3% | Not required | 2026 |
| Nebraska | $653.14 | 99% | -- | 2026 |
| New Jersey | $444.12 | 67.3% | Required | 2026 |
| New Mexico | $688.22 | 104.3% | -- | 2023 |
| Nevada | $733.69 | 111.2% | -- | 2019 |
| New York | $568.18 | 86.1% | -- | 2026 |
| Ohio | $643.33 | 97.5% | -- | 2017 |
| Oklahoma | $621.88 | 94.3% | -- | 2026 |
| South Carolina | $935.02 | 141.8% | -- | 2019 |
| Texas | $619.42* | 93.9% | -- | 2017 |
| Utah | $417.87* | 63.4% | Required | 2026 |
| Virginia | $681.49 | 103.3% | -- | 2023 |
| Vermont | $711.03 | 107.8% | -- | 2026 |
| Washington | $553.07 | 83.9% | -- | 2026 |
| Wisconsin | $528.08 | 80.1% | -- | 2017 |
| Wyoming | $664.93 | 100.8% | -- | 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 89 codes from L1000 to L1990 or every dme & supplies code by number.
Frequently asked questions
How much does Medicaid pay for L1852?
40 state Medicaid programs publish a fee-for-service rate for L1852 (knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf), ranging from $246.09 in North Dakota to $935.02 in South Carolina, with a median of 96.8% of the national Medicare amount. The full table on this page lists every publishing state's current rate.
Which state pays the most for L1852?
South Carolina publishes the highest Medicaid rate for L1852 at $935.02 (141.8% of the national Medicare amount). North Dakota publishes the lowest at $246.09.
Does L1852 require prior authorization under Medicaid?
5 of the 40 publishing states flag L1852 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".