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Billing code 92250 · Physician & professional

92250 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $19.81 for 92250 across 50 states, from $8.71 in New Jersey to $71.29 in Nebraska.

Data as of Oct 5, 202650 statesEvery rate links to its official source

States publishing
50
National median
$19.81units vary by state
Lowest
$8.71New Jersey
Highest
$71.29Nebraska
Answer

What does Medicaid pay for 92250?

50 state Medicaid programs publish a fee-for-service rate for 92250. The national median is $19.81 (units differ between states). Nebraska pays the most, $71.29, and New Jersey the least, $8.71, a 8.2x spread.

Medicare (non-facility, 2026 physician fee schedule): $33.45–$48.53 depending on the state's Medicare locality.

State ranking

92250 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 50 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Nebraska Source · since 2026-07-01$71.29——Plans negotiate; applies out of network—
2Texas Source · since 2025-03-01$47.99——Plans negotiate; applies out of network—
3New Mexico Source · since 2023-07-01$46.45——Plans must pay at least this—
25Delaware Source · since 2026-01-01$19.91——Plans negotiate; applies out of network—
26New Hampshire Source · since 2023-07-01$19.71——Plans negotiate; applies out of network—
27Indiana Source · since 2026-01-01$19.06unit—Plans must pay at least this—
49Rhode Island Source · since 1993-04-01$9.08——Plans negotiate; applies out of network—
50New Jersey Source · since 2026-07-01$8.71——Not classified—
See all 50 states for 92250 — start free

42 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 92250 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 92250?

It depends on the state. Of the 50 states with a published fee-for-service rate, the median is $19.81. Nebraska pays the most ($71.29) and New Jersey the least ($8.71).

Which state pays the highest Medicaid rate for 92250?

Nebraska, at $71.29, effective 2026-07-01.

Do managed-care plans pay the same rate for 92250?

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.