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Billing code 36405 · Physician & professional

36405 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $18.48 for 36405 across 46 states, from $7.45 in Washington to $41.26 in Alaska.

Data as of Oct 5, 202646 statesEvery rate links to its official source

States publishing
46
National median
$18.48units vary by state
Lowest
$7.45Washington
Highest
$41.26Alaska
Answer

What does Medicaid pay for 36405?

46 state Medicaid programs publish a fee-for-service rate for 36405. The national median is $18.48 (units differ between states). Alaska pays the most, $41.26, and Washington the least, $7.45, a 5.5x spread.

Medicare (non-facility, 2026 physician fee schedule): $21.84–$30.75 depending on the state's Medicare locality.

State ranking

36405 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 46 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Alaska Source · since 2026-07-01$41.26——Not classified—
2Alabama Source · since 2026-09-24$40.33——Not classified—
3Montana Source · since 2026-07-01$33.80——Not classified—
23Colorado Source · since 2026-07-01$18.69——Plans negotiate; applies out of network—
24Minnesota Source · since 2026-02-01$18.26——Plans negotiate; applies out of network—
25Kentucky Source · since 2020-01-01$18.08——Plans negotiate; applies out of network—
45Ohio Source · since 2013-12-31$9.39——Plans negotiate; applies out of network—
46Washington Source · since 2026-07-01$7.45——Plans negotiate; applies out of network—
See all 46 states for 36405 — start free

38 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 36405 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 36405?

It depends on the state. Of the 46 states with a published fee-for-service rate, the median is $18.48. Alaska pays the most ($41.26) and Washington the least ($7.45).

Which state pays the highest Medicaid rate for 36405?

Alaska, at $41.26, effective 2026-07-01.

Do managed-care plans pay the same rate for 36405?

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.