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Billing code 90716 · Physician & professional

90716 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $176.43 for 90716 across 43 states, from $2.67 in Washington to $215.00 in Ohio.

Data as of Oct 5, 202643 statesEvery rate links to its official source

States publishing
43
National median
$176.43units vary by state
Lowest
$2.67Washington
Highest
$215.00Ohio
Answer

What does Medicaid pay for 90716?

43 state Medicaid programs publish a fee-for-service rate for 90716. The national median is $176.43 (units differ between states). Ohio pays the most, $215.00, and Washington the least, $2.67, a 80.5x spread.

State ranking

90716 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 43 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Ohio Source · since 2026-10-01$215.00——Plans negotiate; applies out of network—
2Texas Source · since 2026-03-01$206.20——Plans negotiate; applies out of network—
3Michigan Source · since 2026-04-01$202.85——Plans negotiate; applies out of network—
21Oklahoma Source · since 2024-10-01$182.25——Plans must pay at least this—
22Iowa Source · since 2024-03-01$176.43——Plans must pay at least this—
23District of Columbia Source · since 2024-08-01$174.32——Not classified—
42Hawaii Source · since 2024-03-04$4.00——Plans negotiate; applies out of network—
43Washington Source · since 2025-01-01$2.67——Plans must pay at least this—
See all 43 states for 90716 — start free

35 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 90716 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 90716?

It depends on the state. Of the 43 states with a published fee-for-service rate, the median is $176.43. Ohio pays the most ($215.00) and Washington the least ($2.67).

Which state pays the highest Medicaid rate for 90716?

Ohio, at $215.00, effective 2026-10-01.

Do managed-care plans pay the same rate for 90716?

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.