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Billing code 43180 · Physician & professional

43180 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $425.06 for 43180 across 49 states, from $78.38 in Rhode Island to $867.32 in Alabama.

Data as of Oct 5, 202649 statesEvery rate links to its official source

States publishing
49
National median
$425.06units vary by state
Lowest
$78.38Rhode Island
Highest
$867.32Alabama
Answer

What does Medicaid pay for 43180?

49 state Medicaid programs publish a fee-for-service rate for 43180. The national median is $425.06 (units differ between states). Alabama pays the most, $867.32, and Rhode Island the least, $78.38, a 11.1x spread.

State ranking

43180 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 49 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Alabama Source · since 2026-09-24$867.32——Not classified—
2Nebraska Source · since 2026-07-01$852.14——Plans negotiate; applies out of network—
3New Mexico Source · since 2025-01-01$791.68——Plans must pay at least this—
24Oklahoma Source · since 2026-07-01$425.17——Plans must pay at least this—
25Ohio Source · since 2015-01-01$425.06——Plans negotiate; applies out of network—
26District of Columbia Source · since 2026-01-01$419.94——Not classified—
48Missouri Source · since 2022-07-01$82.45——Plans must pay at least this—
49Rhode Island Source · since 2015-01-01$78.38——Plans negotiate; applies out of network—
See all 49 states for 43180 — start free

41 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 43180 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 43180?

It depends on the state. Of the 49 states with a published fee-for-service rate, the median is $425.06. Alabama pays the most ($867.32) and Rhode Island the least ($78.38).

Which state pays the highest Medicaid rate for 43180?

Alabama, at $867.32, effective 2026-09-24.

Do managed-care plans pay the same rate for 43180?

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.