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Billing code 38206 · Physician & professional

38206 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $60.97 for 38206 across 43 states, from $11.15 in Rhode Island to $547.80 in Missouri.

Data as of Oct 5, 202643 statesEvery rate links to its official source

States publishing
43
National median
$60.97units vary by state
Lowest
$11.15Rhode Island
Highest
$547.80Missouri
Answer

What does Medicaid pay for 38206?

43 state Medicaid programs publish a fee-for-service rate for 38206. The national median is $60.97 (units differ between states). Missouri pays the most, $547.80, and Rhode Island the least, $11.15, a 49.1x spread.

State ranking

38206 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 43 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Missouri Source · since 2022-07-01$547.80——Plans must pay at least this—
2Alaska Source · since 2026-07-01$127.45——Not classified—
3New Mexico Source · since 2025-01-01$116.89——Plans must pay at least this—
21Massachusetts Source · since 2026-10-01$61.76——Plans negotiate; applies out of network—
22Oklahoma Source · since 2026-07-01$60.97——Plans must pay at least this—
23Kentucky Source · since 2020-01-01$60.14——Plans negotiate; applies out of network—
42Nebraska Source · since 2026-07-01$17.74——Plans negotiate; applies out of network—
43Rhode Island Source · since 2003-01-01$11.15——Plans negotiate; applies out of network—
See all 43 states for 38206 — start free

35 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 38206 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 38206?

It depends on the state. Of the 43 states with a published fee-for-service rate, the median is $60.97. Missouri pays the most ($547.80) and Rhode Island the least ($11.15).

Which state pays the highest Medicaid rate for 38206?

Missouri, at $547.80, effective 2022-07-01.

Do managed-care plans pay the same rate for 38206?

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.