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Billing code 94375 · Physician & professional

94375 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $21.56 for 94375 across 49 states, from $9.26 in Rhode Island to $54.84 in Nebraska.

Data as of Oct 5, 202649 statesEvery rate links to its official source

States publishing
49
National median
$21.56units vary by state
Lowest
$9.26Rhode Island
Highest
$54.84Nebraska
Answer

What does Medicaid pay for 94375?

49 state Medicaid programs publish a fee-for-service rate for 94375. The national median is $21.56 (units differ between states). Nebraska pays the most, $54.84, and Rhode Island the least, $9.26, a 5.9x spread.

Medicare (non-facility, 2026 physician fee schedule): $37.33–$56.75 depending on the state's Medicare locality.

State ranking

94375 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 49 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Nebraska Source · since 2026-07-01$54.84——Plans negotiate; applies out of network—
2Arizona Source · since 2026-10-01$43.55——Plans negotiate; applies out of network—
3Hawaii Source · since 2026-06-01$41.61——Plans must pay at least this—
24Idaho Source · since 2026-07-01$21.91——Not classified—
25Florida Source · since 2026-01-01$21.56——Plans negotiate; applies out of network—
26Mississippi Source · since 2026-07-01$21.45——Plans must pay at least this—
48New York Source · since 2023-01-01$10.89unit—Plans negotiate; applies out of network—
49Rhode Island Source · since 1993-04-01$9.26——Plans negotiate; applies out of network—
See all 49 states for 94375 — start free

41 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 94375 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 94375?

It depends on the state. Of the 49 states with a published fee-for-service rate, the median is $21.56. Nebraska pays the most ($54.84) and Rhode Island the least ($9.26).

Which state pays the highest Medicaid rate for 94375?

Nebraska, at $54.84, effective 2026-07-01.

Do managed-care plans pay the same rate for 94375?

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.