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Billing code 15221 · Physician & professional

15221 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $91.01 for 15221 across 49 states, from $9.30 in New Jersey to $217.33 in Alaska.

Data as of Oct 5, 202649 statesEvery rate links to its official source

States publishing
49
National median
$91.01units vary by state
Lowest
$9.30New Jersey
Highest
$217.33Alaska
Answer

What does Medicaid pay for 15221?

49 state Medicaid programs publish a fee-for-service rate for 15221. The national median is $91.01 (units differ between states). Alaska pays the most, $217.33, and New Jersey the least, $9.30 per base unit, a 23.4x spread.

Medicare (non-facility, 2026 physician fee schedule): $118.22–$174.22 depending on the state's Medicare locality.

State ranking

15221 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 49 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Alaska Source · since 2026-07-01$217.33——Not classified—
2Alabama Source · since 2026-09-24$204.67——Not classified—
3Wisconsin Source · since 2008-07-01$191.63——Plans negotiate; applies out of network—
24Louisiana Source · since 2025-07-01$101.07——Plans must pay at least this—
25West Virginia Source · since 2026-04-01$91.01——Plans negotiate; applies out of network—
26Maine Source · since 2026-01-01$90.01——Not classified—
48Missouri Source · since 2022-07-01$19.92——Plans must pay at least this—
49New Jersey Source · since 2014-07-01$9.30base unit—Not classified—
See all 49 states for 15221 — start free

41 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 15221 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 15221?

It depends on the state. Of the 49 states with a published fee-for-service rate, the median is $91.01. Alaska pays the most ($217.33) and New Jersey the least ($9.30 per base unit).

Which state pays the highest Medicaid rate for 15221?

Alaska, at $217.33, effective 2026-07-01.

Do managed-care plans pay the same rate for 15221?

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.