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Billing code 40812 · Physician & professional

40812 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $176.72 for 40812 across 50 states, from $9.30 in New Jersey to $456.90 in Alaska.

Data as of Oct 5, 202650 statesEvery rate links to its official source

States publishing
50
National median
$176.72units vary by state
Lowest
$9.30New Jersey
Highest
$456.90Alaska
Answer

What does Medicaid pay for 40812?

50 state Medicaid programs publish a fee-for-service rate for 40812. The national median is $176.72 (units differ between states). Alaska pays the most, $456.90, and New Jersey the least, $9.30 per base unit, a 49.1x spread.

Medicare (non-facility, 2026 physician fee schedule): $249.13–$371.15 depending on the state's Medicare locality.

State ranking

40812 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 50 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Alaska Source · since 2026-07-01$456.90——Not classified—
2Alabama Source · since 2026-09-24$442.83——Not classified—
3Montana Source · since 2026-07-01$395.27——Not classified—
25Colorado Source · since 2026-07-01$179.22——Plans negotiate; applies out of network—
26Arizona Source · since 2026-10-01$174.21——Plans negotiate; applies out of network—
27Indiana Source · since 2026-01-01$166.77unit—Plans must pay at least this—
49Rhode Island Source · since 1996-01-01$12.60——Plans negotiate; applies out of network—
50New Jersey Source · since 2014-07-01$9.30base unit—Not classified—
See all 50 states for 40812 — start free

42 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 40812 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 40812?

It depends on the state. Of the 50 states with a published fee-for-service rate, the median is $176.72. Alaska pays the most ($456.90) and New Jersey the least ($9.30 per base unit).

Which state pays the highest Medicaid rate for 40812?

Alaska, at $456.90, effective 2026-07-01.

Do managed-care plans pay the same rate for 40812?

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.