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Billing code 21462 · Physician & professional

21462 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $1,056.29 for 21462 across 49 states, from $84.00 in Rhode Island to $3,408.61 in Alabama.

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

States publishing
49
National median
$1,056.29units vary by state
Lowest
$84.00Rhode Island
Highest
$3,408.61Alabama
Answer

What does Medicaid pay for 21462?

49 state Medicaid programs publish a fee-for-service rate for 21462. The national median is $1,056.29 (units differ between states). Alabama pays the most, $3,408.61, and Rhode Island the least, $84.00, a 40.6x spread.

Medicare (non-facility, 2026 physician fee schedule): $1,779.91–$2,766.45 depending on the state's Medicare locality.

State ranking

21462 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
1Alabama Source · since 2026-09-24$3,408.61——Not classified—
2Alaska Source · since 2026-07-01$3,196.36——Not classified—
3Montana Source · since 2026-07-01$2,860.05——Not classified—
24Nevada Source · since 2024-01-01$1,110.35——Plans must pay at least this—
25Wisconsin Source · since 2008-07-01$1,056.29——Plans negotiate; applies out of network—
26Indiana Source · since 2026-01-01$1,043.35unit—Plans must pay at least this—
48California Source · since 2026-10-01$152.59——Plans negotiate; applies out of network—
49Rhode Island Source · since 1996-01-01$84.00——Plans negotiate; applies out of network—
See all 49 states for 21462 — 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 21462 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 21462?

It depends on the state. Of the 49 states with a published fee-for-service rate, the median is $1,056.29. Alabama pays the most ($3,408.61) and Rhode Island the least ($84.00).

Which state pays the highest Medicaid rate for 21462?

Alabama, at $3,408.61, effective 2026-09-24.

Do managed-care plans pay the same rate for 21462?

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.