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Billing code 49421 · Physician & professional

49421 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $198.78 for 49421 across 50 states, from $6.30 in Rhode Island to $364.96 in Alaska.

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

States publishing
50
National median
$198.78units vary by state
Lowest
$6.30Rhode Island
Highest
$364.96Alaska
Answer

What does Medicaid pay for 49421?

50 state Medicaid programs publish a fee-for-service rate for 49421. The national median is $198.78 (units differ between states). Alaska pays the most, $364.96, and Rhode Island the least, $6.30, a 57.9x spread.

State ranking

49421 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$364.96——Not classified—
2Alabama Source · since 2026-09-24$356.74——Not classified—
3Iowa Source · since 2013-07-01$341.66——Plans must pay at least this—
25Delaware Source · since 2026-01-01$199.47——Plans negotiate; applies out of network—
26Indiana Source · since 2026-01-01$198.09unit—Plans must pay at least this—
27Wyoming Source · since 2026-07-01$189.22——Not classified—
49New Jersey Source · since 2014-07-01$9.30base unit—Not classified—
50Rhode Island Source · since 1993-04-01$6.30——Plans negotiate; applies out of network—
See all 50 states for 49421 — 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 49421 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 49421?

It depends on the state. Of the 50 states with a published fee-for-service rate, the median is $198.78. Alaska pays the most ($364.96) and Rhode Island the least ($6.30).

Which state pays the highest Medicaid rate for 49421?

Alaska, at $364.96, effective 2026-07-01.

Do managed-care plans pay the same rate for 49421?

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.