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Billing code 21386 · Physician & professional

21386 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $552.49 for 21386 across 49 states, from $9.30 in New Jersey to $1,648.19 in Connecticut.

Data as of Oct 5, 202649 statesEvery rate links to its official source

States publishing
49
National median
$552.49units vary by state
Lowest
$9.30New Jersey
Highest
$1,648.19Connecticut
Answer

What does Medicaid pay for 21386?

49 state Medicaid programs publish a fee-for-service rate for 21386. The national median is $552.49 (units differ between states). Connecticut pays the most, $1,648.19, and New Jersey the least, $9.30 per base unit, a 177.2x spread.

State ranking

21386 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 49 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Connecticut Source · since 2022-07-01$1,648.19——Not classified—
2Alaska Source · since 2026-07-01$1,083.16——Not classified—
3Alabama Source · since 2026-09-24$1,066.63——Not classified—
24Colorado Source · since 2026-07-01$555.56——Plans negotiate; applies out of network—
25Oklahoma Source · since 2026-07-01$552.49——Plans must pay at least this—
26Virginia Source · since 2026-07-01$546.59——Plans negotiate; applies out of network—
48Rhode Island Source · since 1996-01-01$62.16——Plans negotiate; applies out of network—
49New Jersey Source · since 2014-07-01$9.30base unit—Not classified—
See all 49 states for 21386 — start free

41 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 21386 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 21386?

It depends on the state. Of the 49 states with a published fee-for-service rate, the median is $552.49. Connecticut pays the most ($1,648.19) and New Jersey the least ($9.30 per base unit).

Which state pays the highest Medicaid rate for 21386?

Connecticut, at $1,648.19, effective 2022-07-01.

Do managed-care plans pay the same rate for 21386?

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.