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Billing code 15838 · Physician & professional

15838 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $447.40 for 15838 across 28 states, from $70.07 in Rhode Island to $666.85 in Hawaii.

Data as of Oct 5, 202628 statesEvery rate links to its official source

States publishing
28
National median
$447.40units vary by state
Lowest
$70.07Rhode Island
Highest
$666.85Hawaii
Answer

What does Medicaid pay for 15838?

28 state Medicaid programs publish a fee-for-service rate for 15838. The national median is $447.40 (units differ between states). Hawaii pays the most, $666.85, and Rhode Island the least, $70.07, a 9.5x spread.

State ranking

15838 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 28 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Hawaii Source · since 2026-06-01$666.85——Plans must pay at least this—
2New York Source · since 2023-10-01$591.10unit—Plans negotiate; applies out of network—
3Indiana Source · since 2026-01-01$589.54unit—Plans must pay at least this—
14Maryland Source · since 2026-01-01$453.27——Not classified—
15Minnesota Source · since 2026-02-01$441.52——Plans negotiate; applies out of network—
16Illinois Source · since 2024-04-01$430.34——Plans negotiate; applies out of network—
27Missouri Source · since 2022-07-01$97.47——Plans must pay at least this—
28Rhode Island Source · since 1993-04-01$70.07——Plans negotiate; applies out of network—
See all 28 states for 15838 — start free

20 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 15838 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 15838?

It depends on the state. Of the 28 states with a published fee-for-service rate, the median is $447.40. Hawaii pays the most ($666.85) and Rhode Island the least ($70.07).

Which state pays the highest Medicaid rate for 15838?

Hawaii, at $666.85, effective 2026-06-01.

Do managed-care plans pay the same rate for 15838?

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.