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Billing code 64455 · Physician & professional

64455 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $35.31 for 64455 across 48 states, from $7.02 in Rhode Island to $87.40 in Alaska.

Data as of Oct 5, 202648 statesEvery rate links to its official source

States publishing
48
National median
$35.31units vary by state
Lowest
$7.02Rhode Island
Highest
$87.40Alaska
Answer

What does Medicaid pay for 64455?

48 state Medicaid programs publish a fee-for-service rate for 64455. The national median is $35.31 (units differ between states). Alaska pays the most, $87.40, and Rhode Island the least, $7.02, a 12.5x spread.

Medicare (non-facility, 2026 physician fee schedule): $45.67–$62.76 depending on the state's Medicare locality.

State ranking

64455 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 48 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Alaska Source · since 2026-07-01$87.40——Not classified—
2New Mexico Source · since 2025-01-01$71.06——Plans must pay at least this—
3Montana Source · since 2026-07-01$70.43——Not classified—
24Alabama Source · since 2026-08-25$35.73——Not classified—
25West Virginia Source · since 2026-04-01$34.89——Plans negotiate; applies out of network—
26Nebraska Source · since 2026-07-01$34.63——Plans negotiate; applies out of network—
47New Jersey Source · since 2026-07-01$15.00——Not classified—
48Rhode Island Source · since 2009-01-01$7.02——Plans negotiate; applies out of network—
See all 48 states for 64455 — start free

40 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 64455 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 64455?

It depends on the state. Of the 48 states with a published fee-for-service rate, the median is $35.31. Alaska pays the most ($87.40) and Rhode Island the least ($7.02).

Which state pays the highest Medicaid rate for 64455?

Alaska, at $87.40, effective 2026-07-01.

Do managed-care plans pay the same rate for 64455?

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.