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Billing code 11305 · Physician & professional

11305 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $64.62 for 11305 across 50 states, from $5.28 in Rhode Island to $164.20 in Alaska.

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

States publishing
50
National median
$64.62units vary by state
Lowest
$5.28Rhode Island
Highest
$164.20Alaska
Answer

What does Medicaid pay for 11305?

50 state Medicaid programs publish a fee-for-service rate for 11305. The national median is $64.62 (units differ between states). Alaska pays the most, $164.20, and Rhode Island the least, $5.28, a 31.1x spread.

Medicare (non-facility, 2026 physician fee schedule): $89.80–$135.17 depending on the state's Medicare locality.

State ranking

11305 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$164.20——Not classified—
2Alabama Source · since 2026-09-24$147.37——Not classified—
3New Mexico Source · since 2025-01-01$145.45——Plans must pay at least this—
25Connecticut Source · since 2026-01-01$64.70——Not classified—
26Michigan Source · since 2026-01-01$64.54——Plans negotiate; applies out of network—
27Kansas Source · since 2024-08-01$61.99——Plans must pay at least this—
49Washington Source · since 2026-07-01$19.11——Plans negotiate; applies out of network—
50Rhode Island Source · since 1993-04-01$5.28——Plans negotiate; applies out of network—
See all 50 states for 11305 — 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 11305 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 11305?

It depends on the state. Of the 50 states with a published fee-for-service rate, the median is $64.62. Alaska pays the most ($164.20) and Rhode Island the least ($5.28).

Which state pays the highest Medicaid rate for 11305?

Alaska, at $164.20, effective 2026-07-01.

Do managed-care plans pay the same rate for 11305?

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.