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Billing code 0964T · Physician & professional

0964T Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $1,088.84 for 0964T across 6 states, from $37.05 in Iowa to $3,350.09 in Rhode Island.

Data as of Oct 5, 20266 statesEvery rate links to its official source

States publishing
6
National median
$1,088.84units vary by state
Lowest
$37.05Iowa
Highest
$3,350.09Rhode Island
Answer

What does Medicaid pay for 0964T?

6 state Medicaid programs publish a fee-for-service rate for 0964T. The national median is $1,088.84 (units differ between states). Rhode Island pays the most, $3,350.09, and Iowa the least, $37.05, a 90.4x spread.

State ranking

0964T rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 6 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Rhode Island Source · since 2026-07-01$3,350.09——Plans negotiate; applies out of network—
2Delaware Source · since 2026-01-01$1,479.72——Plans negotiate; applies out of network—
3Arkansas Source · since 2026-01-01$1,406.48——Not classified—
6Iowa Source · since 2026-01-01$37.05——Plans must pay at least this—
See all 6 states for 0964T — 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 0964T 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 0964T?

It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $1,088.84. Rhode Island pays the most ($3,350.09) and Iowa the least ($37.05).

Which state pays the highest Medicaid rate for 0964T?

Rhode Island, at $3,350.09, effective 2026-07-01.

Do managed-care plans pay the same rate for 0964T?

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.