49561 Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 5 state Medicaid programs publish a fee-for-service rate for 49561. Rates run from $56.32 in Rhode Island to $934.61 in Florida, with a median of $514.92.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 5
- Median rate
- $514.92units vary by state
- Highest
- $934.61Florida
- Medicare (non-facility)
- —not on the physician fee schedule
49561 rate in every state
One like-for-like fee-for-service rate per state, highest first. Units can differ between states; the per-hour column converts time-based units.
| State | Medicaid rate | Unit | Per hour | Managed-care plans | % of Medicare | Source |
|---|---|---|---|---|---|---|
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $934.61since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | Physician Pediatric Surgery Fee Schedule |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $609.61since 2017-01-01 | — | — | Plans negotiate; applies out of network | — | Physician Maximum Allowed Fee Schedule - |
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $514.92since 2022-07-01 | — | — | Not classified | — | Health First Colorado Physician Fee Sche |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $503.60since 2010-02-01 | — | — | Plans negotiate; applies out of network | — | HFS Practitioner Fee Schedule (effective |
| Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service) | $56.32since 1994-01-01 | — | — | Plans negotiate; applies out of network | — | RI Medicaid Interactive Fee For Service |
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 with the CMS formula; states with several Medicare localities show a range. Confirm rates with the payer before billing.
Frequently asked questions
What does Medicaid pay for 49561?
It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $514.92. Florida pays the most ($934.61) and Rhode Island the least ($56.32).
Which state pays the highest Medicaid rate for 49561?
Florida, at $934.61, effective 2026-01-01.
Do managed-care plans pay the same rate for 49561?
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 table shows the rule for each state, cited to the contract or statute.