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Billing code 49616 · Physician & professional

49616 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $625.67 for 49616 across 50 states, from $96.36 in Oregon to $1,373.93 in Alaska.

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

States publishing
50
National median
$625.67units vary by state
Lowest
$96.36Oregon
Highest
$1,373.93Alaska
Answer

What does Medicaid pay for 49616?

50 state Medicaid programs publish a fee-for-service rate for 49616. The national median is $625.67 (units differ between states). Alaska pays the most, $1,373.93, and Oregon the least, $96.36, a 14.3x spread.

State ranking

49616 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$1,373.93——Not classified—
2Alabama Source · since 2026-09-24$1,282.81——Not classified—
3New Mexico Source · since 2025-01-01$1,266.29——Plans must pay at least this—
25Texas Source · since 2026-09-01$626.83——Plans negotiate; applies out of network—
26Massachusetts Source · since 2026-10-01$624.50——Plans negotiate; applies out of network—
27Vermont Source · since 2026-01-01$608.56——Not classified—
49Pennsylvania Source · since 2023-09-05$107.72——Plans negotiate; applies out of network—
50Oregon Source · since 2026-02-01$96.36——Plans negotiate; applies out of network—
See all 50 states for 49616 — 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 49616 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 49616?

It depends on the state. Of the 50 states with a published fee-for-service rate, the median is $625.67. Alaska pays the most ($1,373.93) and Oregon the least ($96.36).

Which state pays the highest Medicaid rate for 49616?

Alaska, at $1,373.93, effective 2026-07-01.

Do managed-care plans pay the same rate for 49616?

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.