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Billing code 15819 · Physician & professional

15819 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $603.61 for 15819 across 5 states, from $512.90 in Michigan to $1,147.71 in New Mexico.

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

States publishing
5
National median
$603.61units vary by state
Lowest
$512.90Michigan
Highest
$1,147.71New Mexico
Answer

What does Medicaid pay for 15819?

5 state Medicaid programs publish a fee-for-service rate for 15819. The national median is $603.61 (units differ between states). New Mexico pays the most, $1,147.71, and Michigan the least, $512.90, a 2.2x spread.

State ranking

15819 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
1New Mexico Source · since 2025-01-01$1,147.71——Plans must pay at least this—
2Colorado Source · since 2024-07-01$655.20——Plans negotiate; applies out of network—
3Massachusetts Source · since 2026-10-01$603.61——Plans negotiate; applies out of network—
See all 5 states for 15819 — 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 15819 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 15819?

It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $603.61. New Mexico pays the most ($1,147.71) and Michigan the least ($512.90).

Which state pays the highest Medicaid rate for 15819?

New Mexico, at $1,147.71, effective 2025-01-01.

Do managed-care plans pay the same rate for 15819?

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.