53451 Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 6 state Medicaid programs publish a fee-for-service rate for 53451. Rates run from $8.10 in New Jersey to $650.50 in South Dakota, with a median of $228.48.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 6
- Median rate
- $228.48units vary by state
- Highest
- $650.50South Dakota
- Medicare (non-facility)
- —not on the physician fee schedule
53451 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 |
|---|---|---|---|---|---|---|
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services) | $650.50since 2026-07-01 | — | — | Not classified | — | South Dakota Medicaid Physician fee sche |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $482.18since 2026-02-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service | $267.43since 2026-06-01 | — | — | Plans must pay at least this | — | Medicaid Fee-For-Service (FFS) Fee Sched |
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $189.52since 2026-07-01 | — | — | Not classified | — | Health First Colorado Physician Fee Sche |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $35.00since 2022-01-01 | percent of billed charges | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $8.10since 2022-12-01 | base unit | — | Not classified | — | NJMMIS Procedure Master Listing CPTCodes |
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 53451?
It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $228.48. South Dakota pays the most ($650.50) and New Jersey the least ($8.10 per base unit).
Which state pays the highest Medicaid rate for 53451?
South Dakota, at $650.50, effective 2026-07-01.
Do managed-care plans pay the same rate for 53451?
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.