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Billing code 61055 · Physician & professional

61055 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $95.83 for 61055 across 50 states, from $9.30 in New Jersey to $303.80 in Nebraska.

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

States publishing
50
National median
$95.83units vary by state
Lowest
$9.30New Jersey
Highest
$303.80Nebraska
Answer

What does Medicaid pay for 61055?

50 state Medicaid programs publish a fee-for-service rate for 61055. The national median is $95.83 (units differ between states). Nebraska pays the most, $303.80, and New Jersey the least, $9.30 per base unit, a 32.7x spread.

State ranking

61055 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
1Nebraska Source · since 2026-07-01$303.80——Plans negotiate; applies out of network—
2Wisconsin Source · since 2008-07-01$201.48——Plans negotiate; applies out of network—
3Alabama Source · since 2026-09-24$189.09——Not classified—
25New Hampshire Source · since 2023-07-01$95.87——Plans negotiate; applies out of network—
26Delaware Source · since 2026-01-01$95.79——Plans negotiate; applies out of network—
27Colorado Source · since 2026-07-01$93.85——Plans negotiate; applies out of network—
49Rhode Island Source · since 1996-01-01$21.88——Plans negotiate; applies out of network—
50New Jersey Source · since 2014-07-01$9.30base unit—Not classified—
See all 50 states for 61055 — 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 61055 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 61055?

It depends on the state. Of the 50 states with a published fee-for-service rate, the median is $95.83. Nebraska pays the most ($303.80) and New Jersey the least ($9.30 per base unit).

Which state pays the highest Medicaid rate for 61055?

Nebraska, at $303.80, effective 2026-07-01.

Do managed-care plans pay the same rate for 61055?

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.