53866 Medicaid reimbursement rate by state (2026)
Physician and practitioner services (fee schedule). Medicaid pays a median of $102.91 for 53866 across 27 states, from $21.83 in Rhode Island to $204.70 in Montana.
- States publishing
- 27
- National median
- $102.91units vary by state
- Lowest
- $21.83Rhode Island
- Highest
- $204.70Montana
What does Medicaid pay for 53866?
27 state Medicaid programs publish a fee-for-service rate for 53866. The national median is $102.91 (units differ between states). Montana pays the most, $204.70, and Rhode Island the least, $21.83, a 9.4x spread.
Medicare (non-facility, 2026 physician fee schedule): $132.88–$165.17 depending on the state's Medicare locality.
53866 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 27 states with every variant, modifier and effective date.
Frequently asked questions
What does Medicaid pay for 53866?
It depends on the state. Of the 27 states with a published fee-for-service rate, the median is $102.91. Montana pays the most ($204.70) and Rhode Island the least ($21.83).
Which state pays the highest Medicaid rate for 53866?
Montana, at $204.70, effective 2026-07-01.
Do managed-care plans pay the same rate for 53866?
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.