Skip to content
Billing code 21343 · Physician & professional

21343 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $816.70 for 21343 across 50 states, from $36.10 in Pennsylvania to $1,853.94 in Alabama.

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

States publishing
50
National median
$816.70units vary by state
Lowest
$36.10Pennsylvania
Highest
$1,853.94Alabama
Answer

What does Medicaid pay for 21343?

50 state Medicaid programs publish a fee-for-service rate for 21343. The national median is $816.70 (units differ between states). Alabama pays the most, $1,853.94, and Pennsylvania the least, $36.10, a 51.4x spread.

State ranking

21343 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
1Alabama Source · since 2026-09-24$1,853.94——Not classified—
2Alaska Source · since 2026-07-01$1,678.91——Not classified—
3New Mexico Source · since 2025-01-01$1,552.83——Plans must pay at least this—
25Utah Source · since 2026-07-01$827.55——Plans negotiate; applies out of network—
26Mississippi Source · since 2026-07-01$805.84——Plans must pay at least this—
27Vermont Source · since 2026-01-01$796.88——Not classified—
49Rhode Island Source · since 1996-01-01$42.00——Plans negotiate; applies out of network—
50Pennsylvania Source · since 2020-01-01$36.10——Plans negotiate; applies out of network—
See all 50 states for 21343 — 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.

  • Source for every rate
  • Full rate history
  • CSV and API export

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 21343 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 21343?

It depends on the state. Of the 50 states with a published fee-for-service rate, the median is $816.70. Alabama pays the most ($1,853.94) and Pennsylvania the least ($36.10).

Which state pays the highest Medicaid rate for 21343?

Alabama, at $1,853.94, effective 2026-09-24.

Do managed-care plans pay the same rate for 21343?

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.