90654 Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 6 state Medicaid programs publish a fee-for-service rate for 90654. Rates run from $15.45 in Arkansas to $23.19 in New Mexico, with a median of $18.92.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 6
- Median rate
- $18.92units vary by state
- Highest
- $23.19New Mexico
- Medicare (non-facility)
- —not on the physician fee schedule
90654 rate in every state
One like-for-like fee-for-service rate per state, highest first. Units can differ between states; the per-hour column converts time-based units.
| State | Medicaid rate | Unit | Per hour | Managed-care plans | % of Medicare | Source |
|---|---|---|---|---|---|---|
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $23.19since 2025-01-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service CPT |
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $21.20since 2026-07-01 | — | — | Not classified | — | Immunization Rates (07/26) |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $18.92since 2023-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Child and Adolescent Health Center |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $18.92since 2023-01-01 | — | — | Plans negotiate; applies out of network | — | KY Medicaid Preventive fee schedule (202 |
| CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service) | $15.90since 2024-07-01 | — | — | Plans negotiate; applies out of network | — | Medi Cal Physician Administered Drug Rat |
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas ARKids First-B (CHIP) | $15.45since 2025-06-04 | — | — | Not classified | — | Arkansas Medicaid ARKids First-B Screeni |
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 with the CMS formula; states with several Medicare localities show a range. Confirm rates with the payer before billing.
Frequently asked questions
What does Medicaid pay for 90654?
It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $18.92. New Mexico pays the most ($23.19) and Arkansas the least ($15.45).
Which state pays the highest Medicaid rate for 90654?
New Mexico, at $23.19, effective 2025-01-01.
Do managed-care plans pay the same rate for 90654?
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 table shows the rule for each state, cited to the contract or statute.