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Billing code 58611 · Physician & professional

58611 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $56.01 for 58611 across 47 states, from $8.12 in Oregon to $277.94 in New Mexico.

Data as of Oct 5, 202647 statesEvery rate links to its official source

States publishing
47
National median
$56.01units vary by state
Lowest
$8.12Oregon
Highest
$277.94New Mexico
Answer

What does Medicaid pay for 58611?

47 state Medicaid programs publish a fee-for-service rate for 58611. The national median is $56.01 (units differ between states). New Mexico pays the most, $277.94, and Oregon the least, $8.12, a 34.2x spread.

State ranking

58611 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 47 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1New Mexico Source · since 2024-10-01$277.94——Plans must pay at least this—
2Iowa Source · since 2018-09-01$231.88——Plans must pay at least this—
3Nebraska Source · since 2026-07-01$219.33——Plans negotiate; applies out of network—
23Oklahoma Source · since 2026-07-01$58.31——Plans must pay at least this—
24Utah Source · since 2026-07-01$56.01——Plans negotiate; applies out of network—
25Mississippi Source · since 2026-07-01$55.49——Plans must pay at least this—
46Texas Source · since 2026-04-01$9.59——Plans negotiate; applies out of network—
47Oregon Source · since 2026-02-01$8.12——Plans negotiate; applies out of network—
See all 47 states for 58611 — start free

39 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 58611 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 58611?

It depends on the state. Of the 47 states with a published fee-for-service rate, the median is $56.01. New Mexico pays the most ($277.94) and Oregon the least ($8.12).

Which state pays the highest Medicaid rate for 58611?

New Mexico, at $277.94, effective 2024-10-01.

Do managed-care plans pay the same rate for 58611?

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.