92564 Medicaid reimbursement rates by state
Physician and practitioner services (fee schedule). 6 state Medicaid programs publish a fee-for-service rate for 92564. Rates run from $5.75 in Colorado to $21.98 in Maryland, with a median of $14.94.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 6
- Median rate
- $14.94units vary by state
- Highest
- $21.98Maryland
- Medicare (non-facility)
- —not on the physician fee schedule
92564 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 |
|---|---|---|---|---|---|---|
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $21.98since 2026-01-01 | — | — | Not classified | — | Maryland Medicaid Professional Services |
| GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service) | $16.89since 2017-01-01 | — | — | Plans negotiate; applies out of network | — | Physician Maximum Allowed Fee Schedule - |
| IllinoisAny qualified provider (rate does not vary by provider) · Illinois Medicaid (HFS fee-for-service) | $15.20since 2010-02-01 | — | — | Plans negotiate; applies out of network | — | HFS Practitioner Fee Schedule (effective |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $14.67since 2022-01-01 | — | — | Plans negotiate; applies out of network | — | NC Medicaid fee schedule 'Independent Di |
| New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service) | $10.69since 2022-04-01 | — | — | Plans negotiate; applies out of network | — | eMedNY NYS Medicaid Hearing Aid / Audiol |
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $5.75since 2021-07-01 | — | — | Not classified | — | Health First Colorado Physician Fee Sche |
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 92564?
It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $14.94. Maryland pays the most ($21.98) and Colorado the least ($5.75).
Which state pays the highest Medicaid rate for 92564?
Maryland, at $21.98, effective 2026-01-01.
Do managed-care plans pay the same rate for 92564?
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.