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Billing code 45315 · Physician & professional

45315 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $119.84 for 45315 across 50 states, from $9.30 in New Jersey to $395.82 in Alaska.

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

States publishing
50
National median
$119.84units vary by state
Lowest
$9.30New Jersey
Highest
$395.82Alaska
Answer

What does Medicaid pay for 45315?

50 state Medicaid programs publish a fee-for-service rate for 45315. The national median is $119.84 (units differ between states). Alaska pays the most, $395.82, and New Jersey the least, $9.30 per base unit, a 42.6x spread.

Medicare (non-facility, 2026 physician fee schedule): $218.64–$330.77 depending on the state's Medicare locality.

State ranking

45315 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$395.82——Not classified—
2Alabama Source · since 2026-09-24$370.18——Not classified—
3Montana Source · since 2026-07-01$353.02——Not classified—
25Georgia Source · since 2017-01-01$121.54——Plans negotiate; applies out of network—
26Nevada Source · since 2024-01-01$118.13——Plans must pay at least this—
27South Carolina Source · since 2024-07-01$117.97——Plans negotiate; applies out of network—
49Rhode Island Source · since 1996-01-01$16.80——Plans negotiate; applies out of network—
50New Jersey Source · since 2014-07-01$9.30base unit—Not classified—
See all 50 states for 45315 — 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 45315 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 45315?

It depends on the state. Of the 50 states with a published fee-for-service rate, the median is $119.84. Alaska pays the most ($395.82) and New Jersey the least ($9.30 per base unit).

Which state pays the highest Medicaid rate for 45315?

Alaska, at $395.82, effective 2026-07-01.

Do managed-care plans pay the same rate for 45315?

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.