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Billing code 43238 · Physician & professional

43238 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $183.60 for 43238 across 49 states, from $9.30 in New Jersey to $385.34 in Alabama.

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

States publishing
49
National median
$183.60units vary by state
Lowest
$9.30New Jersey
Highest
$385.34Alabama
Answer

What does Medicaid pay for 43238?

49 state Medicaid programs publish a fee-for-service rate for 43238. The national median is $183.60 (units differ between states). Alabama pays the most, $385.34, and New Jersey the least, $9.30 per base unit, a 41.4x spread.

State ranking

43238 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$385.34——Not classified—
2Alaska Source · since 2026-07-01$374.79——Not classified—
3New Mexico Source · since 2025-01-01$330.07——Plans must pay at least this—
24Nebraska Source · since 2026-07-01$185.24——Plans negotiate; applies out of network—
25Connecticut Source · since 2026-01-01$183.60——Not classified—
26Oklahoma Source · since 2026-07-01$182.90——Plans must pay at least this—
48Missouri Source · since 2022-07-01$34.67——Plans must pay at least this—
49New Jersey Source · since 2014-07-01$9.30base unit—Not classified—
See all 49 states for 43238 — 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 43238 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 43238?

It depends on the state. Of the 49 states with a published fee-for-service rate, the median is $183.60. Alabama pays the most ($385.34) and New Jersey the least ($9.30 per base unit).

Which state pays the highest Medicaid rate for 43238?

Alabama, at $385.34, effective 2026-09-24.

Do managed-care plans pay the same rate for 43238?

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.