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0051A Medicaid reimbursement rates by state

Physician and practitioner services (fee schedule). 5 state Medicaid programs publish a fee-for-service rate for 0051A. Rates run from $36.94 in Nebraska 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
5
Median rate
$40.00units vary by state
Highest
$61.77Colorado
Medicare (non-facility)
—not on the physician fee schedule

0051A 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.

StateMedicaid rateUnitPer hourManaged-care plans% of MedicareSource
ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service)$61.77since 2021-09-29——Not classified—Health First Colorado Physician Fee Sche
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 2022-01-03——Not classified—NJMMIS Coronavirus Services procedure co
PennsylvaniaAny qualified provider (rate does not vary by provider) · Pennsylvania Medical Assistance (fee-for-service)$40.00since 2022-01-03——Plans negotiate; applies out of network—52 Pa.B. 3380 Addition to the Medical As
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$36.94since 2021-12-27——Plans negotiate; applies out of network—Nebraska Medicaid ad hoc COVID-19 fee sc

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 0051A?

It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $40.00. Colorado pays the most ($61.77) and Nebraska the least ($36.94).

Which state pays the highest Medicaid rate for 0051A?

Colorado, at $61.77, effective 2021-09-29.

Do managed-care plans pay the same rate for 0051A?

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.

Related Physician & professional codes

Track 0051A in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
Medicaid rates by state