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Billing code 31654 · Physician & professional

31654 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $84.34 for 31654 across 48 states, from $21.16 in Rhode Island to $184.51 in Montana.

Data as of Oct 5, 202648 statesEvery rate links to its official source

States publishing
48
National median
$84.34units vary by state
Lowest
$21.16Rhode Island
Highest
$184.51Montana
Answer

What does Medicaid pay for 31654?

48 state Medicaid programs publish a fee-for-service rate for 31654. The national median is $84.34 (units differ between states). Montana pays the most, $184.51, and Rhode Island the least, $21.16, a 8.7x spread.

Medicare (non-facility, 2026 physician fee schedule): $117.72–$170.16 depending on the state's Medicare locality.

State ranking

31654 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 48 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Montana Source · since 2026-07-01$184.51——Not classified—
2New Mexico Source · since 2025-01-01$168.56——Plans must pay at least this—
3Missouri Source · since 2022-07-01$164.19——Plans must pay at least this—
24Kentucky Source · since 2020-01-01$84.97——Plans negotiate; applies out of network—
25Michigan Source · since 2026-01-01$83.71——Plans negotiate; applies out of network—
26Wisconsin Source · since 2016-01-01$76.45——Plans negotiate; applies out of network—
47Arkansas Source · since 2025-06-13$21.67——Not classified—
48Rhode Island Source · since 2016-01-01$21.16——Plans negotiate; applies out of network—
See all 48 states for 31654 — start free

40 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 31654 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 31654?

It depends on the state. Of the 48 states with a published fee-for-service rate, the median is $84.34. Montana pays the most ($184.51) and Rhode Island the least ($21.16).

Which state pays the highest Medicaid rate for 31654?

Montana, at $184.51, effective 2026-07-01.

Do managed-care plans pay the same rate for 31654?

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.