0031A Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 6 state Medicaid programs publish a fee-for-service rate for 0031A. Rates run from $28.39 in Pennsylvania to $45.87 in Massachusetts, with a median of $39.99.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 6
- Median rate
- $39.99units vary by state
- Highest
- $45.87Massachusetts
- Medicare (non-facility)
- —not on the physician fee schedule
0031A 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 |
|---|---|---|---|---|---|---|
| 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 |
| 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 |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $39.98since 2023-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Child and Adolescent Health Center |
| 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 |
| PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service) | $28.39 | — | — | Plans negotiate; applies out of network | — | 51 Pa.B. 2360 Medical Assistance Program |
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 0031A?
It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $39.99. Massachusetts pays the most ($45.87) and Pennsylvania the least ($28.39).
Which state pays the highest Medicaid rate for 0031A?
Massachusetts, at $45.87, effective 2021-04-01.
Do managed-care plans pay the same rate for 0031A?
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.