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Billing code 21355 · Physician & professional

21355 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $301.88 for 21355 across 50 states, from $18.90 in Rhode Island to $733.80 in Alaska.

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

States publishing
50
National median
$301.88units vary by state
Lowest
$18.90Rhode Island
Highest
$733.80Alaska
Answer

What does Medicaid pay for 21355?

50 state Medicaid programs publish a fee-for-service rate for 21355. The national median is $301.88 (units differ between states). Alaska pays the most, $733.80, and Rhode Island the least, $18.90, a 38.8x spread.

Medicare (non-facility, 2026 physician fee schedule): $396.06–$575.62 depending on the state's Medicare locality.

State ranking

21355 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
1Alaska Source · since 2026-07-01$733.80——Not classified—
2Alabama Source · since 2026-09-24$730.93——Not classified—
3New Mexico Source · since 2025-01-01$634.49——Plans must pay at least this—
25West Virginia Source · since 2026-04-01$303.05——Plans negotiate; applies out of network—
26Maine Source · since 2026-01-01$300.71——Not classified—
27Indiana Source · since 2026-01-01$300.26unit—Plans must pay at least this—
49New Hampshire Source · since 2023-07-01$32.85——Plans negotiate; applies out of network—
50Rhode Island Source · since 1996-01-01$18.90——Plans negotiate; applies out of network—
See all 50 states for 21355 — 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.

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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 21355 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 21355?

It depends on the state. Of the 50 states with a published fee-for-service rate, the median is $301.88. Alaska pays the most ($733.80) and Rhode Island the least ($18.90).

Which state pays the highest Medicaid rate for 21355?

Alaska, at $733.80, effective 2026-07-01.

Do managed-care plans pay the same rate for 21355?

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.