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Billing code 64611 · Physician & professional

64611 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $96.14 for 64611 across 49 states, from $13.78 in Rhode Island to $216.48 in Alaska.

Data as of Oct 5, 202649 statesEvery rate links to its official source

States publishing
49
National median
$96.14units vary by state
Lowest
$13.78Rhode Island
Highest
$216.48Alaska
Answer

What does Medicaid pay for 64611?

49 state Medicaid programs publish a fee-for-service rate for 64611. The national median is $96.14 (units differ between states). Alaska pays the most, $216.48, and Rhode Island the least, $13.78, a 15.7x spread.

Medicare (non-facility, 2026 physician fee schedule): $119.30–$176.99 depending on the state's Medicare locality.

State ranking

64611 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 49 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Alaska Source · since 2026-07-01$216.48——Not classified—
2Montana Source · since 2026-07-01$194.80——Not classified—
3New Mexico Source · since 2025-01-01$188.68——Plans must pay at least this—
24Texas Source · since 2025-03-01$96.27——Plans negotiate; applies out of network—
25West Virginia Source · since 2026-04-01$96.14——Plans negotiate; applies out of network—
26Virginia Source · since 2026-07-01$93.75——Plans negotiate; applies out of network—
48Kansas Source · since 2011-01-01$15.82——Not classified—
49Rhode Island Source · since 2011-01-01$13.78——Plans negotiate; applies out of network—
See all 49 states for 64611 — start free

41 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 64611 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 64611?

It depends on the state. Of the 49 states with a published fee-for-service rate, the median is $96.14. Alaska pays the most ($216.48) and Rhode Island the least ($13.78).

Which state pays the highest Medicaid rate for 64611?

Alaska, at $216.48, effective 2026-07-01.

Do managed-care plans pay the same rate for 64611?

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.