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Billing code 0237T · Physician & professional

0237T Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $1,879.23 for 0237T across 5 states, from $639.07 in Hawaii to $10,431.52 in South Dakota.

Data as of Oct 5, 20265 statesEvery rate links to its official source

States publishing
5
National median
$1,879.23units vary by state
Lowest
$639.07Hawaii
Highest
$10,431.52South Dakota
Answer

What does Medicaid pay for 0237T?

5 state Medicaid programs publish a fee-for-service rate for 0237T. The national median is $1,879.23 (units differ between states). South Dakota pays the most, $10,431.52, and Hawaii the least, $639.07, a 16.3x spread.

State ranking

0237T rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 5 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1South Dakota Source · since 2026-07-01$10,431.52——Not classified—
2Illinois Source · since 2021-09-01$6,462.62——Plans negotiate; applies out of network—
3Indiana Source · since 2024-01-01$1,879.23unit—Plans must pay at least this—
See all 5 states for 0237T — start free

2 more states, with every modifier and provider-type variant, rate history and the plan rule in each state. 14-day free trial, no credit card.

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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; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Track 0237T in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
FAQ

Frequently asked questions

What does Medicaid pay for 0237T?

It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $1,879.23. South Dakota pays the most ($10,431.52) and Hawaii the least ($639.07).

Which state pays the highest Medicaid rate for 0237T?

South Dakota, at $10,431.52, effective 2026-07-01.

Do managed-care plans pay the same rate for 0237T?

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 workspace shows the rule for each state, cited to the contract or statute.