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Billing code 64625 · Physician & professional

64625 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $334.64 for 64625 across 36 states, from $72.96 in Rhode Island to $794.20 in Alaska.

Data as of Oct 5, 202636 statesEvery rate links to its official source

States publishing
36
National median
$334.64units vary by state
Lowest
$72.96Rhode Island
Highest
$794.20Alaska
Answer

What does Medicaid pay for 64625?

36 state Medicaid programs publish a fee-for-service rate for 64625. The national median is $334.64 (units differ between states). Alaska pays the most, $794.20, and Rhode Island the least, $72.96, a 10.9x spread.

Medicare (non-facility, 2026 physician fee schedule): $440.79–$668.06 depending on the state's Medicare locality.

State ranking

64625 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 36 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Alaska Source · since 2026-07-01$794.20——Not classified—
2Montana Source · since 2026-07-01$696.69——Not classified—
3New Mexico Source · since 2025-01-01$652.31——Plans must pay at least this—
18New Hampshire Source · since 2023-07-01$335.10——Plans negotiate; applies out of network—
19Maine Source · since 2026-01-01$334.18——Not classified—
20Michigan Source · since 2026-01-01$316.09——Plans negotiate; applies out of network—
35New Jersey Source · since 2026-07-01$88.95——Not classified—
36Rhode Island Source · since 2020-01-01$72.96——Plans negotiate; applies out of network—
See all 36 states for 64625 — start free

28 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 64625 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 64625?

It depends on the state. Of the 36 states with a published fee-for-service rate, the median is $334.64. Alaska pays the most ($794.20) and Rhode Island the least ($72.96).

Which state pays the highest Medicaid rate for 64625?

Alaska, at $794.20, effective 2026-07-01.

Do managed-care plans pay the same rate for 64625?

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.