0012A Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 7 state Medicaid programs publish a fee-for-service rate for 0012A. Rates run from $30.68 in Hawaii to $61.77 in Colorado, with a median of $40.00.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 7
- Median rate
- $40.00units vary by state
- Highest
- $61.77Colorado
- Medicare (non-facility)
- —not on the physician fee schedule
0012A rate in every state
One like-for-like fee-for-service rate per state, highest first. Units can differ between states; the per-hour column converts time-based units.
| State | Medicaid rate | Unit | Per hour | Managed-care plans | % of Medicare | Source |
|---|---|---|---|---|---|---|
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $61.77since 2021-09-01 | — | — | Not classified | — | Health First Colorado Physician Fee Sche |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $45.87since 2021-04-01 | — | — | Not classified | — | COVID-19 Payment Rates for Certain Commu |
| Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service) | $41.63since 2021-04-01 | — | — | Plans negotiate; applies out of network | — | RI Medicaid Interactive Fee For Service |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $40.00since 2022-01-01 | — | — | Plans negotiate; applies out of network | — | Copy of PADL- Appendix A Published Copy_ |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $40.00since 2021-03-15 | — | — | Not classified | — | NJMMIS Coronavirus Services procedure co |
| NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service) | $36.94since 2022-01-01 | — | — | Plans negotiate; applies out of network | — | Nebraska Medicaid ad hoc COVID-19 fee sc |
| HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service | $30.68since 2024-03-04 | — | — | Plans negotiate; applies out of network | — | Medicaid Fee-For-Service (FFS) Fee Sched |
Rates are per the unit shown for each state; units can differ between states. Medicare amounts are computed from the CMS relative value file and locality cost indices with the CMS formula; states with several Medicare localities show a range. Confirm rates with the payer before billing.
Frequently asked questions
What does Medicaid pay for 0012A?
It depends on the state. Of the 7 states with a published fee-for-service rate, the median is $40.00. Colorado pays the most ($61.77) and Hawaii the least ($30.68).
Which state pays the highest Medicaid rate for 0012A?
Colorado, at $61.77, effective 2021-09-01.
Do managed-care plans pay the same rate for 0012A?
Not necessarily. Each state's plan contracts decide whether plans must pay at least the fee-for-service rate, pay a state-set rate, or negotiate their own. The table shows the rule for each state, cited to the contract or statute.