Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for L3204. 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
30
Median % of Medicare
--
Rate range
$2.00 - $125.00
L3204 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $27.00 | -- | -- | 2026 |
| Arkansas | $50.12* | -- | -- | 2026 |
| California | $40.44 | -- | -- | 2026 |
| Colorado | $58.42 | -- | -- | 2026 |
| Connecticut | $25.03 | -- | -- | 2013 |
| Florida | $37.47 | -- | -- | 2026 |
| Hawaii | $2.00 | -- | -- | 2025 |
| Iowa | $48.40 | -- | -- | 2024 |
| Idaho | $41.33* | -- | Not required | 2025 |
| Illinois | $51.92 | -- | -- | 2026 |
| Kansas | $125.00 | -- | -- | 2006 |
| Kentucky | $67.08 | -- | -- | 2026 |
| Louisiana | $44.14 | -- | -- | 2026 |
| Maine | $47.32 | -- | -- | 2026 |
| Michigan | $20.07 | -- | -- | 2026 |
| Missouri | $37.09* | -- | Not required | 2019 |
| Mississippi | $24.00* | -- | -- | 2026 |
| North Carolina | $31.61 | -- | -- | 2025 |
| Nebraska | $35.78 | -- | -- | 2026 |
| New Jersey | $48.00 | -- | Not required | 2026 |
| New Mexico | $80.73 | -- | -- | 2025 |
| Nevada | $42.20 | -- | -- | 2011 |
| New York | $35.35 | -- | -- | 2026 |
| Ohio | $57.67 | -- | -- | 2010 |
| Texas | $32.73* | -- | -- | 2021 |
| Utah | $70.56* | -- | Required | 2013 |
| Virginia | $36.36 | -- | -- | 2010 |
| Vermont | $50.96 | -- | -- | 2026 |
| Wisconsin | $76.65 | -- | -- | 2008 |
| West Virginia | $36.00 | -- | -- | 2026 |
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
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- 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 150 codes from L3000 to L3995 or every dme & supplies code by number.
Frequently asked questions
How much does Medicaid pay for L3204?
30 state Medicaid programs publish a fee-for-service rate for L3204 (orthopedic shoe, hightop with supinator or pronator, infant), ranging from $2.00 in Hawaii to $125.00 in Kansas. The full table on this page lists every publishing state's current rate.
Which state pays the most for L3204?
Kansas publishes the highest Medicaid rate for L3204 at $125.00. Hawaii publishes the lowest at $2.00.
Does L3204 require prior authorization under Medicaid?
1 of the 30 publishing states flag L3204 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".