Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for L8031. 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
28
Median % of Medicare
73.6%
Rate range
$182.44 - $443.74
L8031 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arkansas | $267.52* | 62.1% | -- | 2026 |
| Arizona | $435.46 | 101.1% | -- | 2026 |
| Colorado | $285.61 | 66.3% | Required | 2026 |
| Connecticut | $313.41 | 72.8% | -- | 2013 |
| District of Columbia | $317.14 | 73.6% | Not required | 2026 |
| Iowa | $348.17 | 80.8% | -- | 2024 |
| Idaho | $333.71 | 77.5% | Not required | 2026 |
| Illinois | $298.07 | 69.2% | -- | 2026 |
| Indiana | $421.95 | 98% | -- | 2026 |
| Kansas | $349.24 | 81.1% | -- | 2026 |
| Kentucky | $346.58 | 80.5% | -- | 2026 |
| Louisiana | $270.79 | 62.9% | -- | 2026 |
| Massachusetts | $340.04 | 78.9% | -- | 2026 |
| Minnesota | $430.39 | 99.9% | Conditional | 2026 |
| Missouri | $315.58* | 73.3% | Required | 2019 |
| Mississippi | $322.98* | 75% | -- | 2026 |
| Nebraska | $374.87 | 87% | -- | 2026 |
| New Hampshire | $443.74 | 103% | Required | 2026 |
| New Mexico | $400.37 | 92.9% | -- | 2025 |
| New York | $182.44 | 42.4% | -- | 2026 |
| Ohio | $302.92 | 70.3% | -- | 2026 |
| Oklahoma | $285.87 | 66.4% | -- | 2026 |
| Texas | $307.79* | 71.5% | -- | 2012 |
| Utah | $311.90* | 72.4% | Not required | 2026 |
| Virginia | $298.78 | 69.4% | -- | 2012 |
| Vermont | $431.66 | 100.2% | -- | 2026 |
| Wisconsin | $242.75 | 56.4% | -- | 2010 |
| West Virginia | $317.14 | 73.6% | -- | 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
- 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 94 codes from L8000 to L8696 or every dme & supplies code by number.
Frequently asked questions
How much does Medicaid pay for L8031?
28 state Medicaid programs publish a fee-for-service rate for L8031 (breast prosthesis, silicone or equal, with integral adhesive), ranging from $182.44 in New York to $443.74 in New Hampshire, with a median of 73.6% of the national Medicare amount. The full table on this page lists every publishing state's current rate.
Which state pays the most for L8031?
New Hampshire publishes the highest Medicaid rate for L8031 at $443.74 (103% of the national Medicare amount). New York publishes the lowest at $182.44.
Does L8031 require prior authorization under Medicaid?
4 of the 28 publishing states flag L8031 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".