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Billing code 25999 · Physician & professional

25999 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $311.21 for 25999 across 8 states, from $20.00 in Indiana to $882.30 in Montana.

Data as of Oct 5, 20268 statesEvery rate links to its official source

States publishing
8
National median
$311.21units vary by state
Lowest
$20.00Indiana
Highest
$882.30Montana
Answer

What does Medicaid pay for 25999?

8 state Medicaid programs publish a fee-for-service rate for 25999. The national median is $311.21 (units differ between states). Montana pays the most, $882.30, and Indiana the least, $20.00 per percent of billed charges, a 44.1x spread.

State ranking

25999 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 8 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Montana Source · since 2025-07-01$882.30——Not classified—
2Idaho Source · since 2025-09-01$760.29——Not classified—
3District of Columbia Source · since 2018-04-01$600.00——Not classified—
7California Source · since 2026-10-01$45.00——Plans negotiate; applies out of network—
8Indiana Source · since 2020-10-15$20.00percent of billed charges—Plans must pay at least this—
See all 8 states for 25999 — start free

3 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 25999 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 25999?

It depends on the state. Of the 8 states with a published fee-for-service rate, the median is $311.21. Montana pays the most ($882.30) and Indiana the least ($20.00 per percent of billed charges).

Which state pays the highest Medicaid rate for 25999?

Montana, at $882.30, effective 2025-07-01.

Do managed-care plans pay the same rate for 25999?

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.