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Billing code 11001 · Physician & professional

11001 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $18.34 for 11001 across 50 states, from $3.36 in Rhode Island to $45.27 in Alaska.

Data as of Oct 5, 202650 statesEvery rate links to its official source

States publishing
50
National median
$18.34units vary by state
Lowest
$3.36Rhode Island
Highest
$45.27Alaska
Answer

What does Medicaid pay for 11001?

50 state Medicaid programs publish a fee-for-service rate for 11001. The national median is $18.34 (units differ between states). Alaska pays the most, $45.27, and Rhode Island the least, $3.36, a 13.5x spread.

Medicare (non-facility, 2026 physician fee schedule): $24.26–$34.89 depending on the state's Medicare locality.

State ranking

11001 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 50 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Alaska Source · since 2026-07-01$45.27——Not classified—
2Wisconsin Source · since 2008-07-01$42.66——Plans negotiate; applies out of network—
3New Mexico Source · since 2025-01-01$38.31——Plans must pay at least this—
25Maine Source · since 2026-01-01$18.37——Not classified—
26West Virginia Source · since 2026-04-01$18.30——Plans negotiate; applies out of network—
27Michigan Source · since 2025-01-01$17.25——Plans negotiate; applies out of network—
49Missouri Source · since 2022-07-01$4.02——Plans must pay at least this—
50Rhode Island Source · since 1996-01-01$3.36——Plans negotiate; applies out of network—
See all 50 states for 11001 — start free

42 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 11001 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 11001?

It depends on the state. Of the 50 states with a published fee-for-service rate, the median is $18.34. Alaska pays the most ($45.27) and Rhode Island the least ($3.36).

Which state pays the highest Medicaid rate for 11001?

Alaska, at $45.27, effective 2026-07-01.

Do managed-care plans pay the same rate for 11001?

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.