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Billing code 52356 · Physician & professional

52356 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $316.42 for 52356 across 49 states, from $61.04 in Rhode Island to $1,067.04 in Nebraska.

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

States publishing
49
National median
$316.42units vary by state
Lowest
$61.04Rhode Island
Highest
$1,067.04Nebraska
Answer

What does Medicaid pay for 52356?

49 state Medicaid programs publish a fee-for-service rate for 52356. The national median is $316.42 (units differ between states). Nebraska pays the most, $1,067.04, and Rhode Island the least, $61.04, a 17.5x spread.

State ranking

52356 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
1Nebraska Source · since 2026-07-01$1,067.04——Plans negotiate; applies out of network—
2Alaska Source · since 2026-07-01$674.87——Not classified—
3New Mexico Source · since 2025-01-01$594.73——Plans must pay at least this—
24Ohio Source · since 2014-01-01$317.67——Plans negotiate; applies out of network—
25District of Columbia Source · since 2026-01-01$316.42——Not classified—
26Virginia Source · since 2026-07-01$316.26——Plans negotiate; applies out of network—
48Arkansas Source · since 2025-06-13$110.02——Not classified—
49Rhode Island Source · since 2014-01-01$61.04——Plans negotiate; applies out of network—
See all 49 states for 52356 — 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 52356 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 52356?

It depends on the state. Of the 49 states with a published fee-for-service rate, the median is $316.42. Nebraska pays the most ($1,067.04) and Rhode Island the least ($61.04).

Which state pays the highest Medicaid rate for 52356?

Nebraska, at $1,067.04, effective 2026-07-01.

Do managed-care plans pay the same rate for 52356?

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.