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Billing code 38230 · Physician & professional

38230 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $168.30 for 38230 across 47 states, from $37.59 in Rhode Island to $1,131.26 in Wisconsin.

Data as of Oct 5, 202647 statesEvery rate links to its official source

States publishing
47
National median
$168.30units vary by state
Lowest
$37.59Rhode Island
Highest
$1,131.26Wisconsin
Answer

What does Medicaid pay for 38230?

47 state Medicaid programs publish a fee-for-service rate for 38230. The national median is $168.30 (units differ between states). Wisconsin pays the most, $1,131.26, and Rhode Island the least, $37.59, a 30.1x spread.

State ranking

38230 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 47 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Wisconsin Source · since 2008-07-01$1,131.26——Plans negotiate; applies out of network—
2Alaska Source · since 2026-07-01$309.87——Not classified—
3Alabama Source · since 2026-09-24$309.41——Not classified—
23Ohio Source · since 2013-09-01$168.39——Plans negotiate; applies out of network—
24Delaware Source · since 2026-01-01$168.30——Plans negotiate; applies out of network—
25Colorado Source · since 2026-07-01$163.38——Plans negotiate; applies out of network—
46California Source · since 2026-10-01$55.40——Plans negotiate; applies out of network—
47Rhode Island Source · since 1996-01-01$37.59——Plans negotiate; applies out of network—
See all 47 states for 38230 — start free

39 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 38230 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 38230?

It depends on the state. Of the 47 states with a published fee-for-service rate, the median is $168.30. Wisconsin pays the most ($1,131.26) and Rhode Island the least ($37.59).

Which state pays the highest Medicaid rate for 38230?

Wisconsin, at $1,131.26, effective 2008-07-01.

Do managed-care plans pay the same rate for 38230?

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.