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Billing code 20612 · Physician & professional

20612 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $45.98 for 20612 across 48 states, from $7.89 in Rhode Island to $112.17 in Alaska.

Data as of Oct 5, 202648 statesEvery rate links to its official source

States publishing
48
National median
$45.98units vary by state
Lowest
$7.89Rhode Island
Highest
$112.17Alaska
Answer

What does Medicaid pay for 20612?

48 state Medicaid programs publish a fee-for-service rate for 20612. The national median is $45.98 (units differ between states). Alaska pays the most, $112.17, and Rhode Island the least, $7.89, a 14.2x spread.

Medicare (non-facility, 2026 physician fee schedule): $60.41–$87.51 depending on the state's Medicare locality.

State ranking

20612 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 48 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Alaska Source · since 2026-07-01$112.17——Not classified—
2Montana Source · since 2026-07-01$95.31——Not classified—
3Alabama Source · since 2026-09-24$92.20——Not classified—
24West Virginia Source · since 2026-04-01$46.12——Plans negotiate; applies out of network—
25Maine Source · since 2026-01-01$45.83——Not classified—
26Nevada Source · since 2024-01-01$43.66——Plans must pay at least this—
47New Jersey Source · since 2026-07-01$15.73——Not classified—
48Rhode Island Source · since 2003-01-01$7.89——Plans negotiate; applies out of network—
See all 48 states for 20612 — start free

40 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 20612 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 20612?

It depends on the state. Of the 48 states with a published fee-for-service rate, the median is $45.98. Alaska pays the most ($112.17) and Rhode Island the least ($7.89).

Which state pays the highest Medicaid rate for 20612?

Alaska, at $112.17, effective 2026-07-01.

Do managed-care plans pay the same rate for 20612?

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.