Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for L4397. 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
38
Median % of Medicare
74.2%
Rate range
$62.00 - $297.84
L4397 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $120.94 | 59.1% | -- | 2026 |
| Arkansas | $160.24* | 78.3% | -- | 2026 |
| Arizona | $184.32 | 90% | -- | 2026 |
| California | $121.49 | 59.3% | -- | 2026 |
| Connecticut | $109.38 | 53.4% | Required | 2017 |
| District of Columbia | $161.01 | 78.6% | Not required | 2026 |
| Florida | $106.87 | 52.2% | -- | 2026 |
| Hawaii | $151.87 | 74.2% | -- | 2025 |
| Iowa | $145.72 | 71.2% | -- | 2018 |
| Idaho | $170.99* | 83.5% | Not required | 2026 |
| Illinois | $126.99 | 62% | -- | 2026 |
| Indiana | $202.19 | 98.8% | -- | 2026 |
| Kansas | $158.32 | 77.3% | -- | 2026 |
| Kentucky | $159.14 | 77.7% | -- | 2026 |
| Louisiana | $137.92 | 67.4% | -- | 2026 |
| Massachusetts | $138.85 | 67.8% | -- | 2026 |
| Maine | $210.28 | 102.7% | -- | 2026 |
| Michigan | $152.61 | 74.5% | -- | 2026 |
| Minnesota | $206.23 | 100.7% | Conditional | 2026 |
| Missouri | $124.91* | 61% | Not required | 2019 |
| Mississippi | $165.93* | 81% | -- | 2026 |
| Montana | $204.74 | 100% | Not required | 2026 |
| North Carolina | $134.63 | 65.8% | -- | 2025 |
| New Hampshire | $181.20 | 88.5% | Not required | 2026 |
| New Jersey | $140.88 | 68.8% | Not required | 2026 |
| New Mexico | $297.84 | 145.5% | -- | 2025 |
| Nevada | $153.53 | 75% | -- | 2019 |
| New York | $116.99 | 57.1% | -- | 2026 |
| Ohio | $95.00 | 46.4% | -- | 2021 |
| Oklahoma | $145.18 | 70.9% | -- | 2026 |
| South Carolina | $167.56 | 81.8% | -- | 2024 |
| Texas | $124.50* | 60.8% | -- | 2014 |
| Utah | $146.52* | 71.6% | Not required | 2026 |
| Virginia | $181.13 | 88.5% | -- | 2026 |
| Vermont | $176.27 | 86.1% | -- | 2026 |
| Washington | $148.75 | 72.7% | -- | 2026 |
| Wisconsin | $62.00 | 30.3% | -- | 2014 |
| Wyoming | $137.87 | 67.3% | -- | 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
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- 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 30 codes from L4000 to L4631 or every dme & supplies code by number.
Frequently asked questions
How much does Medicaid pay for L4397?
38 state Medicaid programs publish a fee-for-service rate for L4397 (static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf), ranging from $62.00 in Wisconsin to $297.84 in New Mexico, with a median of 74.2% of the national Medicare amount. The full table on this page lists every publishing state's current rate.
Which state pays the most for L4397?
New Mexico publishes the highest Medicaid rate for L4397 at $297.84 (145.5% of the national Medicare amount). Wisconsin publishes the lowest at $62.00.
Does L4397 require prior authorization under Medicaid?
2 of the 38 publishing states flag L4397 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".